20001546 Ver 1_Complete File_20010716

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross, Jr., Secretary
Kerr T. Stevens, Director
09WAA
IT 0 0
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NC ENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
If you do not accept any of the conditions of this certification, you may ask for an adjudicatory hearing.
You must act within 60 days of the date that you receive this letter. To ask for a hearing, send a written
petition, which conforms to Chapter 150B of the North Carolina General Statutes to the Office of
Administrative Hearings, P.O. Box 27447, Raleigh, N.C. 27611-7447. This certification and its conditions
are final and binding unless you ask for a hearing.
This letter completes the review of the Division of Water Quality under Section 401 of the Clean Water Act.
If you have any questions, please contact John Hennessy at 919-733-5694, or Deborah Sawyer at 252-946-
6481.
Sincerely,
Ke T. Stevens
Attachment
cc: Wilmington District Corps of Engineers
Corps of Engineers Washington Field Office
DWQ Washington Regional Office
File Copy
Central Files
c:\ncdot\SR 1546\wqc\001546wgc.doc
Wetlands/401 Unit 1650 Mail Service Center Raleigh, North Carolina 27699-1621
Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post consumer paper
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross, Jr., Secretary
Kerr T. Stevens, Director
1 00
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
July 16, 2001
Pitt County
DWQ Project No. 001546
APPROVAL OF 401 Water Quality Certification and ADDITIONAL CONDITIONS and Tar-
Pamlico River Buffer Rules
Mr. C.E. Lassiter, P.E., Division Engineer
NCDOT, Division 2
PO Box 1587
Greenville, NC 27835
Dear Mr. Lassiter:

You have our approval, as described in your application dated January 10, 2001, and in accordance with the
attached conditions and those listed below, to place fill material in 0.17 acres of jurisdictional wetlands.
The project's purpose is the widening and paving of SR 1257 in Pitt County. The project shall be -
constructed in accordance with your application dated January 10, 2001. After reviewing your application, '.
we have decided that this fill is covered by General Water Quality Certification Number 3289. This
certification corresponds to the Nationwide Permit Number 14 issued by the Corps of Engineers. This
approval is also valid for the Tar-Pamlico River Buffer Rules (15A NCAC 2B .0259). In addition, you
should acquire any other federal, state or local permits before you proceed with your project including (but .
not limited to) Sediment and Erosion Control, Non-Discharge and Water Supply Watershed regulations.
This approval will expire when the accompanying 404 permit expires unless otherwise specified in the
General Certification.
This approval is valid solely for the purpose and design described in your application (unless modified
below). Should your project change, you must notify the DWQ and submit a new application. If the
property is sold, the new owner must be given a copy of this Certification and approval letter, and is thereby
responsible for complying with all the conditions. If total wetland fills for this project (now or in the future)
exceed one acre, or of total impacts to streams (now or in the future) exceed 150 linear feet, compensatory
mitigation may be required as described in 15A NCAC 2H.0506 (h) (6) and (7). ). This approval shall
expire with the corresponding Nationwide Permit expires or as otherwise provided in the General
Certification. For this approval to be valid, you must follow the conditions listed in the attached certification
and any additional conditions listed below.
1. Stormwater shall be directed to sheetflow at nonerosive velocities through the protected stream buffers.
2. Upon completion of the project, the NCDOT shall complete and return the enclosed "Certification of
Completion Form" to notify DWQ when all work included in the 401 Certification has been completed.
The responsible party shall complete the attached form and return it to the 401/Wetlands Unit of the
Division of Water Quality upon completion of the project.
Wetlands/401 Unit 1650 Mail Service Center Raleigh, North Carolina 27699-1621
Telephone [phone] FAX [phone]
An Equal opportunity Affirmative Action Employer 50% recycled/10% post consumer paper

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross, Jr., Secretary
Kerr T. Stevens, Director
• •
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
ROAD CROSSING CERTIFICATION GENERAL CERTIFICATION FOR PROJECTS
ELIGIBLE FOR CORPS OF ENGINEERS NATIONWIDE PERMIT NUMBER 14 (ROAD
CROSSINGS), REGIONAL GENERAL PERMIT 198200031 AND NEUSE/TAR-
PAMLICO/RANDLEMAN BUFFER RULES
This General Certification is issued inconformity with the requirements of Section 401, Public Laws 92-
500 and 95-217 of the United States and subject to the North Carolina Division of Water Quality (DWQ)
Regulations in 15A NCAC 2H, Section .0500 and 15A NCAC 2B .0200 for the discharge of fill material to
waters and wetland areas as described in 33 CFR 330 Appendix A (B) (14) of the Corps of Engineers
regulations (i.e., Nationwide Permit No. 14 and Regional General Permit 198200031) and for the Neuse,
Tar-Pamlico and Randleman Buffer Rules (15A NCAC 2B .0233,.0259 and.0250). The category of
activities shall include any fill activity for road crossing and is limited to fill less than one-third of an acre.
This Certification replaces Water Quality Certification Number 2177 issued on November 5, 1987, Water
Quality Certification Number 2666 issued on January 21, 1992, Water Quality Certification Number 2732
issued on May 1, 1992 and Water Quality Certification Number 3103 issued on February 11, 1997. This
WQC is rescinded when the Corps of Engineers re-authorizes Nationwide
Permit 14 or Regional General Permit 198200031 when deemed appropriate by the Director of the DWQ.
The State of North Carolina certifies that the specified category of activity will not violate applicable
portions of Sections 301, 302, 303, 306 and 307 of the Public Laws 92-500 and 95-217 if conducted in
accordance with the conditions hereinafter set forth.
Conditions of Certification:
1. Proposed fill or substantial modification of wetlands or waters (including streams) under this General
Certification requires application to and prior written concurrence from the Division of Water Quality;
2. In accordance with North Carolina General Statute Section 143-215.3D(e), any application for a 401
Water Quality Certification must include the appropriate fee. If a project also requires a CAMA Permit,
one payment to both agencies shall be submitted and will be the higher of the two fees;
3. In accordance with 15A NCAC 2H.0506 (h) compensatory mitigation may be required for impacts to
streams and/or wetlands. In addition, buffer mitigation may be required for any project with Buffer
Rules in effect at the time of application. A determination of buffer, wetland and stream mitigation
requirements shall be made for any Certification for this Nationwide Permit. The most current design
and monitoring protocols from DWQ shall be followed and written plans submitted for DWQ approval
as required in those protocols;
4. For any project involving a stream re-alignment, a stream relocation plan must be included with the 401
application for written DWQ approval. Relocated stream designs should include the same dimensions,
patterns and profiles as the existing channel, to the maximum extent practical. The new channel should
be constructed in the dry and water shall not be turned into the new channel until the banks are
stabilized. Vegetation used for bank stabilization shall be limited to native woody species, and should
include establishment of a 30 foot wide wooded and an adjacent 20 foot wide vegetated buffer on both
sides of the relocated channel to the maximum extent practical. A transitional phase incorporating coir
fiber and seedling establishment is allowable. Also, rip-rap may be allowed if it is necessary to maintain
Wetlands/401 Unit 1650 Mail Service Center Raleigh, North Carolina 27699-1621
Telephone [phone] FAX [phone]
An Equal opportunity Affirmative Action Employer 50% recycled/10% post consumer paper
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross, Jr., Secretary
Kerr T. Stevens, Director
WAJ
4 17k? •
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
the physical integrity of the stream, but the applicant must provide written justification and any
calculations used to determine the extent of rip-rap coverage requested. If suitable stream mitigation is
not practical on-site, then stream impact will need to be mitigated elsewhere;
Impacts to any stream length in the Neuse, Tar-Pamlico and Randleman River Basins requires written
concurrence from DWQ in accordance with 15A NCAC 2B.0233, 15A NCAC 2B .0259 and.0250 and
15A NCAC 2H.0500. New development activities located in the protected 50-foot wide riparian areas
(whether jurisdictional wetlands or not) within the Neuse, Tar-Pamlico and Randleman River Basins
shall be limited to "uses" identified within and constructed in accordance with 15A NCAC 2B .0233,
15A NCAC 2B .0259 and .0250. All new development shall be located, designed, constructed, and
maintained to have minimal disturbance to protect water quality to the maximum extent practicable
through the use of best management practices. Activities listed as "exempt" from these rules do not need
to apply for written concurrence under this Certification;
6. Placement of culverts and other structures in waters, streams, and wetlands must be placed below the
elevation of the streambed to allow low flow passage of water and aquatic life unless it can be shown to
DWQ that providing passage would be impractical. Design and placement of culverts and other
structures including temporary erosion control measures shall not be conducted in a manner that may
result in dis-equilibrium of wetlands or stream beds or banks, adjacent to or upstream and down stream .
of the above structures. The applicant is required to provide evidence that the equilibrium shall be
maintained if requested in writing by DWQ. Additionally, when roadways, causeways or other fill
projects are constructed across FEMA-designated floodways or wetlands, openings such as culverts or
bridges must be provided to maintain the natural hydrology of the system as well as prevent constriction
of the floodway that may result in destabilization of streams or wetlands;
7. If this Certification is used to access building sites, all lots owned by the applicant must be buildable
without additional fill beyond that allowed under other General Certifications. Deed restrictions must be
placed on the remaining wetlands and streams on these lots to restrict future wetland and stream fill.
DWQ shall be sent copies of all deed restrictions applied to these lots;
P-
8. That appropriate sediment and erosion control practices which equal or exceed those outlined in the
most recent version of the "North Carolina Sediment and Erosion Control Planning and Design Manual"
or the "North Carolina Surface Mining Manual" whichever is more appropriate (available from the
- Division of Land Resources (DLR) in the DENR Regional or Central Offices) shall be in full
compliance with all specifications governing the proper design, installation and operation and
maintenance of such Best Management Practices in order to assure compliance with the appropriate
turbidity water quality standard;
9. All sediment and erosion control measures placed in wetlands or waters shall be removed and the natural
grade restored within two months after the Division of Land Resources has released the project;
10. Measures shall be taken to prevent live or fresh concrete from coming into contact with waters of the
state until the concrete has hardened;
Wetlands/401 Unit 1650 Mail Service Center . Raleigh, North Carolina 27699-1621
Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post consumer paper
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross, Jr., Secretary
Kerr T. Stevens, Director
4 • •
IT
NC ENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
11. This Certification shall be utilized for roads from natural high ground to natural high ground. The
Certification for Nationwide Permit 18 may not be used in conjunction with this Certification to create
high ground for road access;
12. If an environmental document is required, this Certification is not valid until a Finding of No
Significant Impact (FONSI) or Record of Decision (ROD) is issued by the State Clearinghouse. All
water quality-related conditions of the FONSI or ROD shall become conditions of this Certification;
13. That additional site-specific conditions may be added to projects proposed under this Certification in
order to ensure compliance with all applicable water quality and effluent standards;
14. When written concurrence is required, the applicant is required to use the enclosed "Certification of
Completion Form" to notify DWQ when all work included in the 401 Certification has been completed;
15. Concurrence from DWQ that this Certification applies to an individual project shall expire three years
from the date of the cover letter from DWQ or on the same day as the expiration date of the
corresponding Nationwide Permit 14 and Regional General Permit 198200031 whichever is sooner.
Non-compliance with or violation of the conditions herein set forth by a specific fill project may result in
revocation of this Certification for the project and may also result in criminal and/or civil penalties.
The Director of the North Carolina Division of Water Quality may require submission of a formal
application for individual certification for any project in this category of activity, if it is determined that the
project is likely to have a significant adverse effect upon water quality or degrade the waters so that existing
uses of the wetland, stream or downstream waters are precluded.
Public hearings may be held for specific applications or group of applications prior to a Certification
decision if deemed in the public's best interest by the Director of the North Carolina Division of Water
Quality.
Effective date: 1 June 2000
DIVISION OF WATER QUALITY
By
Kerr T. Stevens
Director
WQC # 3289
Wetlands/401 Unit 1650 Mail Service Center Raleigh, North Carolina 27699-1621
Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post consumer paper
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross, Jr., Secretary
Kerr T. Stevens, Director
DWQ Project No.:
Applicant:
4 00
1
NCDENR
NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
County:
Project Name:
Date of Issuance of 401 Water Quality Certification:
Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable Buffer
Rules, and any subsequent modifications, the applicant is required to return this certificate to the
401/Wetlands Unit, North Carolina Division of Water Quality, 1621 Mail Service Center, Raleigh, NC,
27699-1621. This form may be returned to DWQ by the applicant, the applicant's authorized agent, or the
project engineer. It is not necessary to send certificates from all of these.
Applicant's Certification
I, I , hereby state that, to the best of my abilities, due care and
diligence was used in the observation of the construction such that the construction was observed to be built
within substantial compliance and intent of the 401 Water Quality Certification and Buffer Rules, the
approved plans and specifications, and other supporting materials.
Signature:
Date:
Agent's Certification
I, , hereby state that, to the best of my abilities, due care and
diligence was used in the observation of the construction such that the construction was observed to be built
within substantial compliance and intent of the 401 Water Quality Certification and Buffer Rules, the
approved plans and specifications, and other supporting materials.
Signature:
Engineer's Certification
Partial Final
I, , as a duly registered Professional Engineer in the State
of North Carolina, having been authorized to observe (periodically, weekly, full time) the construction of
the project,for the Permittee hereby state that, to the best of my abilities, due care and diligence was used in
the observation of the construction such that the construction was observed to be built within substantial
compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and
specifications, and other supporting materials.
Signature
Date
Registration No.
Wetlands/401 Unit 1650 Mail Service Center Raleigh, North Carolina 27699-1621
Telephone [phone] FAX [phone]
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07/10/2001 16:31 NCDOT DIV 2 OPERATIONS 3 89197336893
State of North Carolina
Department of Environment
and Natural Resources
Division of Welter Quality
Michael F. Easley, Governor
Sherri Evans-Stanton, Acting Secretary
Kerr T. StAvens, Director
Mr, Bill ailmore, P.E., M. nager
Planning and Environmental Branch
North Carolina Departfnent of Transportation
P.O. BL)x 25201
l2aleigh, North Carolina, ?7t511
N0.496 D02
01 L
NCDENR
January 10, 2001
. tv.
Re- Permit Application for the grading anti paving of SR 1257 in Pitt County
DWO No. 001546
Dear Mr. Gilmore!
The Division of Dater Quality has reviewed your stibmitial fora 401 Water Quality Certification for the
aforementioned project. Reviaw of your tappliQuion revealed it lacking necessary inforrnation required for
making an informed permir decision. The permit application was deficient in the following areas:
There were no drawings that show the scream buffers being impucied,
There was no table of proposed impacts to riparian buffers,
• There was no information detailing the WOLIN of impact to Lawrence Run Creels,
e Th(Te was no discussion on the removal of the old road4ad and culvert,
• Thcrc were no drawings detailing rho pmposecl stormwater design to address the requirements imposed
by the Tar-Pamlico Riparian Buffer Mules 05A NCAC 2B .0259).
Therefore, pursuant. 10 15A NCAC 2h .0507(a)(5), we will have to place the pemli.t tipplication on hold
until we are supplied the necessary information. Finahermore, until the information is receives] by the NC
Division of Water Quality, we r6quest (by copy of this letter) that the US Army Corps of Engineers pl_=
the permit application on (told.
.Hopefully, we can work together lc7 expeclite the processing Of your permit applic460 n- If you havr ur%Y
questions or mquirc additional information, please contact Jahn 1-Iennessy at 919-733-5694.
Sincerely,
cc! Deborah Savuyer, DWQ Washington Regiunttl
Mike Bell, USAC1r Washinllon Field Office
Central JRIts
CtlncdaL\3R ?357w?+?:esgondenve?OpIS4$hld,ttor
1 ?_'y yj
R. Dorney
r Qw0 ity Certific:.tiu Program
Wetlandsl4171 Unit 1621 Mail Service Center Raleigh. Norih Carolina 37699-1621
Telephone 919,733-1786 FAX [phone]
An Equal Oppontunity Affinnuive Action Employer 50%re9y9lecul0%p051 consumer paper
07/10/2001 16:31 NCDOT DIV 2 OPERATIONS + 89197336893 N0.496 P03
DWQ 1D: . CORPS ACTION ID: T
NATIONWIDE PERMIT REQUESTID (PROVIDE NATIONWIDE PERMIT 4) 14
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR. NATIONWIDE PERMITS THAT REQUIRE:
1. NOTIFICATION TO THE CORPS OF ENGINEERS
2. APPLICATION FOR SECTION 401 CERTIFICATION
3. COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT
SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THE APPROPRIATE FIELD
OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SHEET), SEVEN
COPIES MUST BE SENT TO THE NC DIVISION OF WATER. +QUALITY
.ATTN: JOHN DORNEY, 4401 REEDY CREEK. ROAD, RA.L FICH, NC
27607. PLEASE PRINT OR
t. OWNER'S NAME; NCOOT
2. MAILING ADDRESS- P.O. BOX 1597
SUBDIVISION NAME:
CITY: GREENVILLE STAT& N.C. ZIP CODR: 27935
PROJECT LOCATION ADDRESS, INCLUDING SUBDWISION NAME (IF DIF ERFNT FROM
MAI LING ADDRESS ABOVE):
SR 1257 Pitt County
3. TELEPHONE, NUMBER- (HOME) (WORD) 252-830-3490
4. IF APPLICABLP: AGETIT'S NAMr- OR PZSPONSIOL.E CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
Jay Johnson, NCDOT Division 2 rmironmental Officer,
5. LOCATION OF WORK (PROVIDE A MAP, PREFE)7AI3LY A COVY OF USGS TOPOGRAPHIC MAP
OR AERIAL PiI.OTOGRAPIIY WITH SCALE):
COUNTY; Pitt - NEAREST TOWN: Bruce
USGS TOPO GreeaviIle NW` Quadrangle Lat; 77 29 08 Lang: 35 39 25
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ECT.) SR_ 1257 Cattandale road
6. IMPACTED OR NEAREST STREAM/RIVER: Lawrence Run Creek R]'VE.R BASIN: Tar-Pam
? (a) I$ PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL $A<JTWAf,TLIt, (SA), HIGH
QUALITY OV'ATEPS (HQW), OUTSTANDING RESOURCE WATERS (OItW), WATER SUPPLY (WS-1
OR WS-II)? YES a NO x IF YES, EXPLAIN: ,
(U) IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA Or EN 4tONM> NTAL CONCERN (AEC)? YES [j NO x
(C) IF THE PROJECT IS LOCATED WITHIN A COASTAL COUNT'Y' (SEE PAGE 7 FOR LIST OF
COASTAL COUNTIES), WHAT IS THE LAND USE PLAN (LUP) DESIGNATION? N/A
07/10/2001 16:31 NCDOT DIV 2 OPERATIONS 4 89197336893 NO.496 D04
(a) HAVE ANY SECTION 4.44 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PR04Cr. YES ? NO x IF YES, PROVIDE ACTION I.D. NUMBER OF PREVIOUS PERMIT AND
AWY ADDITIONAL INFORMATION (INCLUDE P140TOCOPY OF 401 CERTIFICATION):
(b) ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE FUTURE?
YES ? NO x IF YES, DES0915E ANTICXPATED WORK:
4_ (a) ESTIMATED TOTAL NUMBERS OF ACRES IN TRACT OF LAND: NIA
(b) ESTIMATED TOTAL NI MFR OF ACRES OF WETLANDS LOCATED ON PROJECT SITE: N/A
10. (a) NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY-
FILLING: .17 EXCAVATION:
FLOODING; OTHER :
DRAINAGE: TOTAL ACRES TO BE IMPACTED- .17
(h) (1) STREAM CHANNEL TO BE, IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED,
PROVIDE DISTANCE BOTFI BEFORE AND AFTER RELOCATION:
LENGTH BEFORE: FT AFTER: FT
WIDTH BEFORE (based on normal high water contours): FT
AVERAGE DEPTH B1croRr,: t FT AFTER: I FT
(b) (2) STREAM CHANNEL IMPACTS WILL RESULT FRONT: (CHECK ALL THAT APPLY)
OPEN CHANNEL .RELOCATION: PLACEMENT OF PIPE IN CHANNEL: X
CHANNL-1, EXCAVATION: X CONSTRUCTION OF A DAM/FLOODING:
OTHER:
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF TI-1E WATERS14ED
DRAINING TO THE POND? WHAT IS THE EXPECTED POND SURFACE AREA?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT TO BE USED? (ATTACH PLANS; 91/2 BY 1 I DRAWINGS ONLY)
Grade, Sase, and Pave read SR 1257 to end. Realign 1257
13, PURPOSE OF PROPOSED WORK: To widen and pave 9R 1257
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS (INCLUDE ANY MEASURES TAKEN TO .MTNI.MIZE WETLAND IMPACTS)
There are wetlands on the reali gnment section of road, Only filling the areas needed to facilitate the new
road and safe shoulder sl2pe.
13. YOU ARE REQUIRED TO CONTACT THE US FISH AND WILDLIFE SERVICE AND/OR
NATIONAL MARINE FISHERIES SERVICE REGARDING THE, PRESENCE OF ANY FEDERALLY
LISTED OR PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL
HABITAT IN THE PERMIT AREA THAT MAY BE AFFECTED 13Y THE PROPOSED PROJECT.
DATE CONTACTED: 11116=00
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) REGARDING THE PRESENCE OF HISTOKIC PROPERTIES IN TFIE PERMIT AREA
WHICH MAYBE AFFECTED BY THE PROPOSED PROJECT. DATE CONTACTED 1111612000.
07/10/2001 16:31 NCDOT DIV 2 OPERATIONS -> 89197336893 N0.496 905
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OT THE USE OF PUBLIC
(STATE) LAND? YES ® NO ? (IF NO, 00 TO 16)
(a) IF YES, DOES TITS PROJECT REQUIRE PREPARATION OF AN ENVIRONMENTAL
DOCUMENT PURSUANT TO Tf E REQUIREMENTS OF THE NORTFI CAROLINA
FNVIRONMENTA.L POLICY ACT"? YES El NO n
(b) IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT Of ADMINISTRATION STATE CLEARINGHOUSE YES ? NO
IF ANSWER 17b I3 YES, TI lEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE STATE
CLEARINGHOUSE WITH THE NORTH CAROLINA ENVIRONMENTAL POLICY ACT.
QUESTIONS REGARDING TIC STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS, CHRYS BAGOETT, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 WEST JONES STRECT, P-aLEIGH,
NORTH CAROLINA 27603-8003, TEL SPHONE [phone].
18, THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF PROPOSED
ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OF FILL MATEKIAL INTO
WETLANDS:
(a) WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, LAKES, AN D
PONDS ON TI4F PROPERTY (FORNATIONWIUE PERMIT NUMBERS 14, 18, 21, 26, 29, AND 38).
ALL STREAM (INTERNIITTENTAND PERMANENT) ON THE PROPERTY MUST BE SHOWN ON
THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS 50 FRET OF I INCH EQUALS 100 FEET
OF THEIR EQUIVALENT.
(b) IF AVAILABLE, REPRESENTATIVE P140TOGRAPFT OF WETLANDS TO BE IMPACTED BY
PRODUCT.
(c) IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA SHEETS
RELEVANT TO T14E PLACEMENT OF THE DELINEATION LINE.
(d) ATTACH A COPY OF THE S'TORMWATER MANAGEMENT PLAN IF REQUIPLED,
(e) WHAT IS LAND USE OF SURROUNDING PROPERTY? Residential/Agriculture
(f) IF APPLICABLE, WHAT IS PROPOSED METT-1013 OF SEWAGE DISPOSAL? NIA
SIGNED AND DATED AGENT AUTHORIZATION LETTER. IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE US MAY NOTICE IMPACTED PRIOR TO:
I. ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2. EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF WATER. QUALITY
CERTWICATION, AND
3. (IN THE TWENTY COASTAL COUNTIES ONLY), A LETTER FROM THE NORTH
CAROLINA DIVISION OF COASTAL MANACBMENT STATING TIME PROPOSED
ACTIVITY IS CONSISTENT WIT THE NORTH CAROLINA COASTAL MANAGEMENT
PROGRAM,
l? J!
OWNER'S/AGENTS SIGNATURE DATE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER rROM
THE OWNr-R IS PRONADED).
Mc.p
07/10/2001 16:31 NCDOT DIV 2 OPERATIONS 4 89197336893 N0.496 D06
07/10/2001 16:31 NCDOT DIV 2 OPERATIONS 8?9?r1.97336893 NO.496 P07
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.??vt 1 ? ~'fI•?*m ?_ ? ??????I•••r?M '.Tr t' _•??a'?1C1??','r.'?, ?• ]??!b 1
?i`'-?'?+.[M'f?rS?a d?J . + ?•: ? ?'•?+:r;.,`4'• f?. v`F?" •i•.\''•'Y?? r?? +J+?'•
::(Y??'li"+t?i:?• &' . •?... .. .r.'sS?- ..:ASS .Y's:" ?.._? ., ?•'
., Q
Y W
d r `h
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07/10/2001 16:31 NCDOT DIV 2 OPERATIONS + 89197336893 NO.496 D08
6 "?
DATA FORM
ROUTINE WETLAND DETERMINATION
(1887 COE Wetlands Delineation Manual)
Project/site: 5 P, 12 -6 Date:
Applicant/Owner: Q C PnT County: ) ff
Investigator; 'laze State: _
Do Norm' aI Circumstances exist on the site? No Community Ia:
Is the site sigrtificarltly disturbed (Atypical Situation)? Yes +M Transect ID:
Is file area a potential Problem Area? Yes o Plot 10:
If needed explain on reverse.
VEGETATION
neGlea SVmtum Indicargr 130mimmnt Plaint Sooty. Stratum Indicator

ti
4. iAfJ" A* 12.

Peron' of Dominant Species that are 49L. FACW or FAC
excludin FAC-1, ---- ----
Remorks:
HYDROLOGY
_ Recarded Data (Describe In Remants):
_ Stream, Lake, or -ride Gauge
AadW Notognphs
er
Rocarom Peal Avallable weuand Hy irology Indicators: .
Primary Indicators:
_ Inundated
_ Saturated In Upper 12 Inches
_ Water Mona
DrIR LiM
Sediment Depoelts
Fleld Observations; _ oralnaga Patterns in Wetlenus
Secondary IntlicAtora (Z or more roqulrad):
Imp Of suftee water. `y (in.) ..,--, QlddlZed Real Chanoela In Upper 12 aocnes
-Water-Stained Leaves
Depth to Fran Water In Pit: '(in,) Local Sol] Survey Data
- FAC-Noutrol Teat
Soil.
Depm to Saturated Other (ap}aln in Remarks)
/
Ramada: (?Jltr_.."F A'-d-0,5 lj 1 S food WWA
B2 Appondlx l3 91apk end Exarnpie> DOta Forms
07/10/2001 16:31 NCDOT DIV 2 OPERATIONS + 89197336893
1? ? -C?I*x & V'k
DATA pORM
ROUTINE WETLAND DETERMINATION
(1087 COE Wetlands Delineation Manual)
NO.496 P09
Project/site: l S'7
_
Date; c al:
Applicant/Owner: kS?T__?_`_ a --- County: P)
Investigator: Stater
Do Normal Circumstances exist on the site? 6No Community ID:
Is the site significantly disturbed (Atypical Situation)? Yes drD Transact 10:
Is the area a potential Problem Area? Yes Plot ID:
If needod, explain on revoreo.
VEGETATION
Damirteni Plant 221ci2a Stratum Dominant Plant Soeri? stratum Indicator

a. Lam. c..?v. Jam.. ? ev.
9•?
?" -??'-??_ 11.
..
.
.
.
?
---
4. ,...,?.?..,.........??.
?
.... ?.
? ?.....
...
12.
- -- ------- -
61 14. -
-
- --
-
--- - r ?
?
,

Par-snt or Dorldnant Species that are 013L. FACW or FAG .-
e>oCWQIn FAC.1.
Remarks:?+?A+u?f tjt3 C? i?. f+Cyl1 t SY1.7?+-Wry
HYDROLOGY
- Recorded Dole (Daacribe In Remarks); Wauand Hydrology Indicators,
- stresro. Lake, & Tide Gauge Primary indlcalors:
_ Aerial Phonographs - Inundated
M
iter T Saturated In upper 12 was
- t kr ieGOrded Data AvahaVe
r ... Water Merits
_ Drift Lines
-Sediment Deposits
Flerd Observations: _ Drainage Petteme In wetlands
Sacolldaty Indlentom (2 or more required).'
Depth of Surface Water, Qxlilizea Root CMarinels In Upper 72 InOW
Wsler-stainrad Leaves
Depth to Free Water in Pit Local Sag Survey Data
_ FAC-Noutrat Tom
Depth to Saturated Soil: -
J Qn,} _ Otner (Sxplaln In Remarks)
g
Remarks, a
82 ApperldixB Blank and Example Data Forme
07/10/2001 16:31 NCDOT DIV 2 OPERATIONS 4 89197336893 NO.496 1310
Phone Conversation Record
Talked with: DOB: rNnw.
PM
/
of: National Marine Fisheries Phone*, 252.729.9090
Re: Filling 7 03 sq. ft. of 404 wetlands under NWP in Pt' COuntY•
I Pieced Call P Called
my Message Rapl
Party'a Message Reply
Action or Follow Up Necessary
Refer to: SO J 5. File 0:
5ipned:
(/ t/ V
Phone Conversation Record
Talked with: Date: Timd
PM
Of: Stats Historic Preservation Office Phone # : 9'19-733-4763
Re; Filling aq. R. of 404 wetlands under IVyIUP in County.
I aced Call Party Coiled
My Message Reply
Party's Mcssaea Repay .J'
7'h? t?,o?ry?'+r va«7` ? L+ ? I?'a""
S
j

Action or Follow Up Necessary
Refer to; File 4;
Signed;
611/ G
07/10/2001 16:31 NCDOT DIV 2 OPERATIONS 4 89197336893
NO. 496 D11
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42020
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
MICHAEL F. EASLEY DIVISION OF HIGHWAYS LINDO TIPPETT
GOVERNOR SECRETARY
June 14, 2001
Mr. John Hennessy
DENR
Division of Water Quality
1650 Mail Service Center
Raleigh, N.C. 27699-1650
Subject: DWQ Project # 001546 Pitt Co.
Dear Mr. Hennessy,
In reference to our onsite meeting yesterday in Pitt Co. SR 1257 Cottondale Rd. I very much
appreciate you taking the time to meet with me to make the non-stream call. Please find enclosed a copy
of the completed NCDWQ Stream Classification Form. This now clears us from the January 10, 01 letter
from DWQ requesting buffer information and are now ready to proceed with this project pending the
issuance of the 401 Water Quality Certification. Are you the point of contact for a 401 on this project?
Should you have any questions concerning this please call. Thank you for your time in this matter.
Sincerely,
?Ia 94_4_??
Jay Johnson
NCDOT Division 2 Environmental Officer
Cc:
Neii-Lassiter, P.E.
Dwayne Alligood, P. E.
Danny,Taylor, P.E.
Stonie Woolard
DIVISION TWO • P.O. BOX 1587 • GREENVILLE, N.C. 27835
PHONE [phone] • FAX [phone]
iw1Cl)W0 Stream ChlSS1t1Ctil1Oll hf)rm
I'ruj i t Namc:,SR 125-7 Rivc l- Basin: AX
Absent Weak NIod ate _ Strong,
3 2 0
--- 3 2 - I ------
2 3
)1NT S: - - --------
1 AVQ I'rr,iecl Numher: Nearest Named Stream: Lalitudc: Signalurc: /
-
Date: .tdw
1)SGS QUAb: Location/Directitms:
'I`t'LI;:1SE NOTE: f/'cer
«lrralor and lundoivrrcr rr),rcc. (hut the•lenlra•e is a Haiti-Hurtle rlilc•h, lhen rise al'this,firrnr is not necessary.
Uso, i/-in Nre best pru/is.cional Purr cment of the ei,alrnrhrr, the ferrlure is a mint-nmele ditch and nol a mmli/ied natural streanr-t/ris
raring s_yslern should not be a.%ed-*
Primary Field I11dia1t01-S: (CircleOtte MimherPer Line)
/WG
4--Z-5 ?tccts?wQ7?• S ,r?r» G ?"
1. Ge(Ji1111-1: olt?t y ^ b • 'nt Weak -moderate Stroh
II>: TI lrn. A Il;lfl?:-I'nu; Sedu?_nc('?.. -----------° 1 - 2 i
2) )"Thc USDA'Texture In Sireambed ------------ ------.--
D111c1cm Frmu Surrcu ll ill- Terrain? )
-...._ ----- ------ .... _.:
- 2 3
i) Ait: Natur..i1 I_c\,ccs Piesci)t' ------------- 2 3
Si)tut?uS'? -- ---- 0 ---- - ? 3
5) Is There An Active (Or Relic) -- - ----------------
I Inrid Main Presenl?
3
0) I "1'I c (hanncl Braided? 1? ---- - ----- -- -- 3-- ------- - ---- ----
7) Aie _I2_cent AIluyial_Uehitsits Present'?_ .0, I ----- - 3 --- --------
81 A 1arLk,f'ull Be .-Ii Piesent?1 - --- -- ----- --
9) Is A C (mlinu uis Bed & Bank Present'? ----- ; 0 r 1 -- 2 --- -- 3?------ -"--
\ Il fled F
. It,rnk Cmime{i lh Ditr•yin.Anr/ WIT/lOU/Snnro:4 /hen .S'tare'=(>
111) I A _ Ordci Or (;ic it i Channel (As Indicated
(?n I;olic) N aII1Ltd/Or In I=field) Present? _ Yes=3 0 =0
- ?-- ----- - -----
PRIfl1,1 RY 6'Ii01110RP110L0GY INDICATOR POINTS: ---- - --- -
II.IlydroloL, y Absent Weak Moderate ?%tron
1) Is'l'h%re ?\ (;rctundwaler -
1=lciwil.)is?ha? ('resent? ___-- --- I ? 3
PRIAL4RI'll YDROLOGY INDICATOR POINTS:
-- -- --- --"- --
111. Biology
11 A-1 l_ii?renis R;uxs 1'resei>t In Streambed'?
3) ilr_ Rc lan
rctfed Pts ['reseal in Sfreambed'?
31_Is-I'cril?I)vtct11 Present'?---
11.Arc_Ili v;dves.l'resenl;'..-
PRMLI RY IIIOI,OGY INDICATOR N
Secondary Field lndieatol-S' (Circle Otte Number Per Line)
1. Geontor halo g ' Absent
'
' Weak Moderate Stroh
11-.1_,.
1
1cre A Ilcad Cut Present Ili Channel? fi 5 1

2Z is_Here ,4 C;rade Gtntrctl P<tinhtli ( halinel . 1.5
,__-_ -
3) Does'I'opoip-aphy Indicate A
0
Na)k,)ral Dr (fill e-Way_?- -- 5
-
.S
ECONDARYGIsOHORPiIOLOGYINDICATORPOINTS: . - ----I.S
I1.11}'drology _ Absent Weak Moderate Strom
1) IS Tills Year's (Or Last's) Lel-I itter
1'reslatl In Strcait)Itcd? 1.5 1 .5
2) Is SaOilnent On Plants (Oi Debris Present? 0 5 1 - ,--? - -----
S
'
3Lre Wrack Lines Present'? 5 1 •
.5
----
4) Is Water In Channel And >48 Mrs. Since ?`?--- .
5 1 1
5
---
.
Last l:nutrn Rain? t "NU77_I mi , Indicated 1„ i!9 rebate Sk i"l'h .s Step And NS BeEa-
'
• 1.5
5) 1>.
I
here Water in Channel Durill Dry 5 1 - ------

('undititt!is Oi_in Growil - seasrtn ?-_-_-- 1.5
(?. A).e I I dri!,;_S( Is -Present In Sides Of Channel (Or in i-leadcut)? Ye s=1..5 - No=O ----- ---------
;iECOADARY 11YDROLOGY INDICATOR POINTS: - - ---- ------ -- ----------
I I L Biology ? Absent Weak Moderate Strou
1)_Are FiA I_'rese)tt?•---- s ,
2ZAi_? Arrphiliians Present-? ----
y Ad_-aticTtnlees Present?
41 VCr)vfish I'r?s nl'i--_ _--- _--
Arc:
G) \n: lrc?ti Oxidii;i_ng 13;u_Lcria/fungus Prose
7.) Is.l?ilai)?lltous I'resc_itl??
C unity: / •" I valualm.: 470401
;r
8) Ax Wcllaod Planes In Slicatttbed?
S.1 v
t 'V(1/Zi: I;"i i,kd Air. enre QI AP Plaw.% hr Sryrami.,ed ? I 1
1 ,V',;a,Ih:;r.•;5'kL','7ria.S lINl,li_SS_S;tl!!'i'e_se,?l?_----? -
SECONDARY BIOLOGY INDICATOR POINTS:
Mostly FACW
.75
Mostly FAC nIwAly FACU
.5 0
Mostly UI'1,
.0
1
TO TA L POINT/ ,S1'riurul + S?ellwndar (= (/ Greater Than Or lignal To 19 Points The Stream Ls Al Lease /nler/rril/cnl)
State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
Sherri Evans-Stanton, Acting Secretary
Kerr T. Stevens, Director
January 10, 2001
Mr. Bill Gilmore, P.E., Manager
Planning and Environmental Branch
North Carolina Department of Transportation
P.O. Box 25201
Raleigh, North Carolina, 27611
Re: Permit Application for the grading and paving of SR 1257 in Pitt County
DWQ No. 001546
Dear Mr. Gilmore:
The Division of Water Quality has reviewed your submittal for a 401 Water Quality Certification for the
aforementioned project. Review of your application revealed it lacking necessary information required for
making an informed permit decision. The permit application was deficient in the following areas:
• There were no drawings that show the stream buffers being impacted,
• There was no table of proposed impacts to riparian buffers,
• There was no information detailing the amount of impact to Lawrence Run Creek,
• There was no discussion on the removal of the old roadbed and culvert,
• There were no drawings detailing the proposed stormwater design to address the requirements imposed
by the Tar-Pamlico Riparian Buffer Rules (15A NCAC 2B .0259).
Therefore, pursuant to 15A NCAC 2h .0507(a)(5), we will have to place the permit application on hold
until we are supplied the necessary information. Furthermore, until the information is received by the NC
Division of Water Quality, we request (by copy of this letter) that the US Army Corps of Engineers place .
the permit application on hold.
Hopefully, we can work together to expedite the processing of your-permit application. If you have any
questions or require additional information, please contact John Hennessy at 919-733-5694.
Sincerely,
G
in R. Dorney
ater Quality Certificatio Program
cc: Deborah Sawyer, DWQ Washington Regional
Mike Bell, USACE Washington Field Office
Central Files
C:\ncdot\SR 1257\correspondence\001546hid.doc
Wetlands/401 Unit 1621 Mail Service Center Raleigh, North Carolina 27699-1621
Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post consumer paper

4? r DEC 1 4so
p015
DWQ ID: CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #) 14
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1. NOTIFICATION TO THE CORPS OF ENGINEERS
2. APPLICATION FOR SECTION 401 CERTIFICATION
3. ' COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT
SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THE APPROPRIATE FIELD
OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SHEET). SEVEN 7
COPIES MUST BE SENT TO THE NC DIVISION OF WATER QUALITY
ATTN: JOHN DORNEY, 4401 REEDY CREEK ROAD, RALEIGH, NC
27607. PLEASE PRINT OR TYPE. t
1. OWNER'S NAME: NCDOT
2. MAILING ADDRESS: P.O. BOX 1587
SUBDIVISION NAME:
CITY: GREENVILLE STATE: N.C. ZIP CODE: 27835
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
SR 1257 Pitt County
3. TELEPHONE NUMBER: (HOME) (WORK) 252-830-3490
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
Jay Johnson, NCDOT Division 2 Environmental Officer.
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC MAP
OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: Pitt - NEAREST TOWN: Bruce
USGS TOPO Greenville NW Quadrangle Lat: 77 29 08 Long: 35 39 25
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ECT.) SR 1257 Cottondale road
6. IMPACTED OR NEAREST STREAM/RIVER: Lawrence Run Creek RIVER BASIN: Tar-Pam
? (a) IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER, (SA), HIGH
QUALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW), WATER SUPPLY (WS-I
OR WS-II)? YES ? NO x IF YES, EXPLAIN:
(b) IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES ? NO x
n ?
m ?
c rn
o -z-?
(c) IF THE PROJECT IS LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR LIST OF
COASTAL COUNTIES), WHAT IS THE LAND USE PLAN (LUP) DESIGNATION? N/A
(a) HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROJECT? YES [] NO x IF YES, PROVIDE ACTION I.D. NUMBER OF PREVIOUS PERMIT AND
ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401 CERTIFICATION):
(b) ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE FUTURE?
YES n NO x IF YES, DESCRIBE ANTICIPATED WORK:
9. (a) ESTIMATED TOTAL NUMBERS OF ACRES IN TRACT OF LAND: N/A
(b) ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE: N/A
10. (a) NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: .17 EXCAVATION:
FLOODING: OTHER :
DRAINAGE : TOTAL ACRES TO BE IMPACTED:. 17
(b) (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED,
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION:
LENGTH BEFORE: FT AFTER: FT
WIDTH BEFORE (based on normal high water contours): FT
AVERAGE DEPTH BEFORE: 1 FT AFTER: 1 FT
(b) (2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL: X_
CHANNEL EXCAVATION: X_ CONSTRUCTION OF A DAM/FLOODING:
OTHER:
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
DRAINING TO THE POND? WHAT IS THE EXPECTED POND SURFACE AREA?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT TO BE USED? (ATTACH PLANS; 81/2 BY 11 DRAWINGS ONLY)
Grade, Base, and Pave road SR 1257 to end. Realign 1257
13. PURPOSE OF PROPOSED WORK: To widen and pave SR 1257
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS)
There are wetlands on the realignment section of road. Only filling the areas needed to facilitate the new
road and safe shoulder slope.
15. YOU ARE REQUIRED TO CONTACT THE US FISH AND WILDLIFE SERVICE AND/OR
NATIONAL MARINE FISHERIES SERVICE REGARDING THE PRESENCE OF ANY FEDERALLY
LISTED OR PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL
HABITAT IN THE PERMIT AREA THAT MAY BE AFFECTED BY THE PROPOSED PROJECT.
DATE CONTACTED: 11/16/2000
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) REGARDING THE PRESENCE OF HISTORIC PROPERTIES IN THE PERMIT AREA
WHICH MAY BE AFFECTED BY THE PROPOSED PROJECT. DATE CONTACTED 11/16/2000.
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OT THE USE OF PUBLIC
(STATE) LAND? YES ® NO ? (IF NO, GO TO 16)
(a) IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIRONMENTAL
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA
ENVIRONMENTAL POLICY ACT? YES ? NO
(b) IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE YES ? NO
IF ANSWER 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE STATE
CLEARINGHOUSE WITH THE NORTH CAROLINA ENVIRONMENTAL POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS BAGGETT, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 WEST JONES STREET, RALEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone]. R
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF PROPOSED
ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OF FILL MATERIAL INTO
WETLANDS:
(a) WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, LAKES, AND
PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 18, 21, 26, 29, AND 38).
ALL STREAM (INTERMITTENT AND PERMANENT) ON THE PROPERTY MUST BE SHOWN ON
THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS 50 FEET OF 1 INCH EQUALS 100 FEET
OF THEIR EQUIVALENT.
(b) IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED BY
PRODUCT.
(c) IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA SHEETS
RELEVANT TO THE PLACEMENT OF THE DELINEATION LINE.
(d) ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
(e) WHAT IS LAND USE OF SURROUNDING PROPERTY? Residential/Agriculture
(fl IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL? N/A
SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE US MAY NOT BE IMPACTED PRIOR TO:
1. ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2. EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF WATER QUALITY
CERTIFICATION, AND
3. (IN THE TWENTY COASTAL COUNTIES ONLY), A LETTER FROM THE NORTH
CAROLINA DIVISION OF COASTAL MANAGEMENT STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLINA COASTAL MANAGEMENT
PROGRAM,
OWNER'S/AGENT'S SIGNATURE DATE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED).
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DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Delineation Manual)
Project/Site: Date: irfl?
Applicant/Owner: N C D? County: P1 i

Investigator: _ °?nn oti, -
State: _ j) .e,
Do Normal Circumstances exist on the site? (YO No Community ID: _
Is the site significantly disturbed (Atypical Situation)? Yes cj!g) Transect ID: -
Is the area a potential Problem Area? Yes Plot ID:
If needed, explain on reverse.
VEGETATION
Do rant Plant Soecies Stratum Indicator Dominant Plant Soecies Stratum Indicator
1 ?ls?,r i /mow 0 V for. Fc?? 3-' 9. ----

2.K.IOVJ,,. ---
1o.--
-- - -
4. 1,Z)v
5.--- --
- -
13.--- -

6.-- -----
---- -- - -
14.-

7.- --
8.-- -- -
---- -
--- ---- -
15.-- --- -
16. -
- -- --
Percent of Dominant Species that are OBL, FACW or FAC
(excluding FAC-l. '5 -A ----------------------------------
Remarks: ?? ( l ?G S yQ re 5 E'iM
HYDROLOGY
- Recorded Data (Describe in Remarks):
- Stream, Lake, or Tide Gauge
Aerial Photographs
_G?er
No Recorded Data Available Wetland Hydrology Indicators:
Primary Indicators:
_ Inundated
- Saturated in Upper 12 Inches
- Water Marks
- Drift Lines
_ Sediment Deposits
Field Observations: - Drainage Patterns in Wetlands
Secondary Indicators (2 or more required):
Depth of Surface Water: ` (in.) - Oxidized Root Channels in Upper 12 Inches
_ Water-Stained Leaves
Depth to Free Water in Pit: ? (in.) _ Local Soil Survey Data
_ FAC-Neutral Test
Depth to Saturated Soil: (in.) - Other (Explain in Remarks)
a
Remarks: ?? N
p[ r?eLo `/ j S I/Jr? gn-.?
Y g
82 Appendix B Blank and Example Data Forms
SOILS
Map Unit Name
(Series and Phase): Drainage Class:
Taxonomy (Subgroup): Field Observations
Confirm Mapped Type? Yes No
Profile Description: 7 T ?i
Depth Matrix Color Mottle Colors Mottle Abundance/ Texture, Concretions,
(inches) Horizon (Munsell Moist) ?(Munsell Moist) Size/Contrast ' Structure- etc.
Hydric Soil Indicators:
f
Kstosol _ C retions
Histic don _ gh Organic Content in Surface Layer in Sandy Soils
_ Sulfdic Odor Organic Streaking in Sandy Soils
Aq is Moisture Regime =_t<ed on Local Hydric Soils List
%-R?'ducing Conditions _?kisted on National Hydric Soils List
t!_ yed or Low-Chroma Colors _ Other (Explain in Remarks)
Remarks:
WETLAND DETERMINATION
Hydrophytic Vegetation Present? ® No (Circle) (Circle)
Wetland Hydrology Present? No
Hydric Soils Present? Qs-:> No Is this Sampling Point Within a Wetland? /a No
Remarks: w 'a? ' _ Q
Approved by HQUSACE 3/92
Appendix B Blank and Example Data Forms 83

DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Delineation Manual)
Project/Site: S 2 19 5 7 Date: ?> i o a
Applicant/Owner: JLqQL_ County: f
Investigator: ? ?o b?Lw• _ State: &. Iwo
Do Normal Circumstances exist on the site? eP No Community ID: -
Is the site significantly disturbed (Atypical Situation)? Yes (T?) Transect ID:

Is the area a potential Problem Area?
Yes (Z Co_) _
Plot ID:
If needed, explain on reverse.
VEGETATION
Dominant Plant Soecies Stratum Indicator Dominant Plant Species Stratum Indicator
1.1 A- w r / e

3._?2t• .?+•.w Jc+?cr? -_ ,`.err 347o Fict . g•A 11.-------
- ----
5. Q,ybus S.O. R.?s?a?oy i-e? 3•P 13. -

6.-
-- -- --- -
14.-- --
-
8.-- - -- ---- -- 16.- - --- -
---- -- -
Percent of Dominant Species that are OBL, FACW or FAC
(excluding FAC-).
Remarks: V" E?-? AN?P? 11 ?cJ / _ 1? L 5 ?? C
HYDROLOGY
- Recorded Data (Describe in Remarks):
- Stream, Lake, or Tide Gauge
- Aerial Photographs
/Other
- No Recorded Data Available Wetland Hydrology Indicators:
Primary Indicators:
- Inundated
- Saturated in Upper 12 Inches
_ Water Marks
- Drift Lines
_ Sediment Deposits
Field Observations: - Drainage Patterns in Wetlands
Secondary Indicators (2 or more required):
Depth of Surface Water: (in.) - Oxidized Root Channels in Upper 12 Inches

? 2 _ Water-Stained Leaves
Depth to Free Water in Pit: (in.) - Local Soil Survey Data
_ FAC-Neutral Test
Depth to Saturated Soil: i EIZ (in.) - Other (Explain in Remarks)
Remarks: ??_t ?`? ?`,tvolagy 1 S /Jc9`i' pSSL?V?
B2 Appendix B Blank and Example Data Forms
SOILS
Map Unit Name
(Series and Phase): LM A-- Gt-S tj V, /
(? ?-. Drainage Class: _--
- -?-
Taxonomy (Subgroup): Lg?G?y? /jig Field Observations
- Confirm Mapped Type? Yes No
Profile Description: '
Depth Matrix Color Mottle Colors Mottle Abundance/ Texture, Concretions,
(inches) Horizon (Munsell Moist) (Munsell Moist) Size/Contrast Structure. etc.
10-7 - - - / U ?/a ---- ------ S-.?-??o eti M,%
Hydric Soil Indicators: t
- Histosol - Concretions
- Histic Epipedon - High Organic Content in Surface Layer in Sandy Soils
- Sulfidic Odor Organic Streaking in Sandy Soils
Aquic Moisture Regime Listed on Local 1-lydric Soils List
Reducing Conditions - Listed on National Hydric Soils List
- Gleyed or low-Chroma Colors - Other (Explain in Remarks)
Remarks: w Q 0. v? ?j 0-t (t 5 G
WETLAND DETERMINATION
Hydrophytic Vegetation Present? e® No (Circle) (Circle)
Wetland Hydrology Present? Yes QE)
Hydric Soils Present? Yes 1® Is this Sampling Point Within a Wetand? Yes
Remarks: /( j O n CNe GLw.?-GC O? G C ?Gti v p? yv, "do
Approved by HQUSACE 3/92
Appendix B Blank and Example Data Forms B3
Phone Conversation Record
Talked with:

bY'+42-1, ? Date:

/1// ( 1;2a cp-o Time:

as
PM
Of: National Marine Fisheries Phone #: [phone]
Re: Filling 72G3 sq. ft. of 404 wetlands under NWP in ?t County.
I placed Call F?j Pa Called
My Message Reply
Party's Message Reply
d l''C
Action or Follow Up Necessary
JlT o ,?.e,.
Refer to: S se 12-5-7 File #:
Signed:
U 00
Phone Conversation Record
Talked with: Date: Time:
PM
Of: State Historic Preservation Office Phone # : [phone]
Re: Filling 7?aZ?o3 sq. ft. of 404 wetlands under NWP in P ! County.
I placed Call Party Called
My Message Reply
Party's Message Reply

Action or Follow Up Necessary
Refer to: 5 ?a 5" -7 File #:
Signed:
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pp1546
DWQ ID: CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #) 14
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1. NOTIFICATION TO THE CORPS OF ENGINEERS
2. APPLICATION FOR SECTION 401 CERTIFICATION
3. COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT
SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THE APPROPRIATE FIELD
OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SHEET). SEVEN (7)
COPIES MUST BE SENT TO THE NC DIVISION OF WATER QUALITY,
ATTN: JOHN DORNEY, 4401 REEDY CREEK ROAD, RALEIGH, NC
27607. PLEASE PRINT OR TYPE. • ,
1. OWNER'S NAME: NCDOT
2. MAILING ADDRESS: P.O. BOX 1587
SUBDIVISION NAME:
CITY: GREENVILLE STATE: N.C. ZIP CODE: 27835
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
SR 1257 Pitt County
3. TELEPHONE NUMBER: (HOME) (WORK) 252-830-3490
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
Jay Johnson, NCDOT Division 2 Environmental Officer.
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC MAP
OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: Pitt - NEAREST TOWN: Bruce
USGS TOPO Greenville NW Quadrangle Lat: 77 29 08 Long: 35 39 25
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ECT.) SR 1257 Cottondale road
6. IMPACTED OR NEAREST STREAM/RIVER: Lawrence Run Creek RIVER BASIN: Tar-Pam
? (a) IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER, (SA), HIGH
QUALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW), WATER SUPPLY (WS-I
OR WS-II)? YES F-1 NO x IF YES, EXPLAIN:
(b) IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES Ej NO x
rn
m
M z
C= -1
(c) IF THE PROJECT IS LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR LIST OF
COASTAL COUNTIES), WHAT IS THE LAND USE PLAN (LUP) DESIGNATION? N/A
(a) HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROJECT? YES ? NO x IF YES, PROVIDE ACTION I.D. NUMBER OF PREVIOUS PERMIT AND
ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401 CERTIFICATION):
(b) ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE FUTURE?
YES ? NO x IF YES, DESCRIBE ANTICIPATED WORK:
9. (a) ESTIMATED TOTAL NUMBERS OF ACRES IN TRACT OF LAND: N/A
(b) ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE: N/A
10. (a) NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: .17 EXCAVATION:
FLOODING: OTHER :
e
DRAINAGE : TOTAL ACRES TO BE IMPACTED:. 17
(b) (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED,
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION:
LENGTH BEFORE: FT AFTER: FT
WIDTH BEFORE (based on normal high water contours): FT
AVERAGE DEPTH BEFORE: 1 FT AFTER: 1 FT
(b) (2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL: X_
CHANNEL EXCAVATION: X_ CONSTRUCTION OF A DAM/FLOODING:
OTHER:
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
DRAINING TO THE POND? WHAT IS THE EXPECTED POND SURFACE AREA?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT TO BE USED? (ATTACH PLANS; 81/2 BY 11 DRAWINGS ONLY)
Grade, Base, and Pave road SR 1257 to end. Realign 1257
13. PURPOSE OF PROPOSED WORK: To widen and pave SR 1257
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS)
There are wetlands on the realip-nment section of road. Only filline the areas needed to facilitate the new
road and safe shoulder slope.
15. YOU ARE REQUIRED TO CONTACT THE US FISH AND WILDLIFE SERVICE AND/OR
NATIONAL MARINE FISHERIES SERVICE REGARDING THE PRESENCE OF ANY FEDERALLY
LISTED OR PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL
HABITAT IN THE PERMIT AREA THAT MAY BE AFFECTED BY THE PROPOSED PROJECT.
DATE CONTACTED: 11/16/2000
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) REGARDING THE PRESENCE OF HISTORIC PROPERTIES IN THE PERMIT AREA
WHICH MAYBE AFFECTED BY THE PROPOSED PROJECT. DATE CONTACTED 11/16/2000.
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OT THE USE OF PUBLIC
(STATE) LAND? YES ® NO ? (IF NO, GO TO 16)
(a) IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIRONMENTAL
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA
ENVIRONMENTAL POLICY ACT? YES Ej NO
(b) IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE YES [:] NO
IF ANSWER 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE STATE
CLEARINGHOUSE WITH THE NORTH CAROLINA ENVIRONMENTAL POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS BAGGETT, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 WEST JONES STREET, RALEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF PROPOSED
ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OF FILL MATERIAL INTO
WETLANDS:
(a) WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, LAKES, AND
PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 18, 21, 26, 29, AND 38).
ALL STREAM (INTERMITTENT AND PERMANENT) ON THE PROPERTY MUST BE SHOWN ON
THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS 50 FEET OF 1 INCH EQUALS 100 FEET
OF THEIR EQUIVALENT.
(b) IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED BY
PRODUCT.
(c) IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA SHEETS
RELEVANT TO THE PLACEMENT OF THE DELINEATION LINE.
(d) ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
(e) WHAT IS LAND USE OF SURROUNDING PROPERTY? Residential/Agriculture
(fl IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL? N/A
SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE US MAY NOT BE IMPACTED PRIOR TO:
1. ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2. EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF WATER QUALITY
CERTIFICATION, AND
3. (IN THE TWENTY COASTAL COUNTIES ONLY), A LETTER FROM THE NORTH
CAROLINA DIVISION OF COASTAL MANAGEMENT STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLINA COASTAL MANAGEMENT
PROGRAM, (??Ll
OWNER'S/AGENT'S SIGNATURE DATE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED).
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DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Delineation Manual)
Project/Site: _ 5 1? 10 6-7 Date: -/
Applicant/Owner: N C. tD. !s2LI _ County: P1 ff

Investigator: _ of%V'% -
State: N •e. ?-
Do Normal Circumstances exist on the site? <Z No Community ID: -
Is the site significantly disturbed (Atypical Situation)? Yes <to) Transect ID:
Is the area a potential Problem Area? Yes Plot ID:
If needed, explain on reverse.
VEGETATION
D nant Plant S i Stratum Indicator Dominant Plant Species Stratum Indicator
0 d Sor. ,emu -3
0
3.
5. 13.
---
6. -- -
-- ---- -- -- --- - - -
14.--
- --
7. -- --
.------ --_ --
-

8._- ---

--- ------

-
16.-
----- --- --
of Dominant Species that are OBL, FACW or FAC c
Percent
(excluding FAC-l. --2 -----------------------------------
Remarks: ?? ?? l ?? s 14Y^Q 5 ply C-
HYDROLOGY
- Recorded Data (Describe in Remarks):
- Stream, Lake, or Tide Gauge
Aerial Photographs
ther
-jforded Data Available Wetland Hydrology Indicators:
Primary Indicators:
_ Inundated
- Saturated in Upper 12 Inches
_ Water Marks
_ Drift Lines
- Sediment Deposits
Field Observations: _ Drainage Patterns in Wetlands

- Secondary indicators (2 or more required):
Depth of Surface Water: ? (in.) - Oxidized Root Channels in Upper 12 Inches
- Water-Stained Leaves
Depth to Free Water in Pit: ? (in.) _ Local Soil Survey Data
_ FAC-Neutral Test
Depth to Saturated Soil: _(in.) - Other (Explain in Remarks)
Remarks: 0(1-6 Lo'

132 Appendix B Blank and Example Data Forms
SOILS
Map Unit Name
(Series and Phase):
Draina
Cl

Taxonomy (Subgroup): r C. ge
ass:
Field Observations
?qJ
,o 0.t e5 Confirm Mapped Type? Yes N
,
o
j
Profil D c riotion•
Depth Matrix Color
(inches) Horizon (Munsell Moist) Mottle Colors Mottle Abundance/ Texture, Concretions,
(Munsell Moist) Si
/c
'
ze
ontrast
Structure, etc.
_ J r2 00
Hydric Soil Indicators:
f
M Histosol C retions
Histic Epipedon
Sulfidic Odor gh Organic Content in Surface Layer in Sandy Soils
_ Organic Streaking in Sandy Soils
AVic Moisture Regime
' ad on Local Hydric Soils List.
ducing Conditions
?- R?? meted on National Hydric Soils List
?Gleyed or Low-Chroma Colors _ Other (Explain in Remarks)
Remarks: WC4L l q.HO? Z-5o a ra ?`?s
WETLAND DETERMINATION
Hydrophytic Vegetation Present? ® No (Circle) (Circle)
Wetland Hydrology Present? inNo
Hydric Soils Present? No Is this Sampling Point Within a Wetland? b Ng
Remarks:
Approved by HQUSACE 3/92
Appendix B Blank and Example Data Forms B3

DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Delineation Manual)
Project/Site:
- Date: /f i o

Applicant/Owner: ptDol-
_?

? _
County: f
Investigator: - - _ State: &C?.
Do Normal Circumstances exist on the site? dSP No Community ID:
Is the site significantly disturbed (Atypical Situation)? Yes (M?) Transect ID:
Is the area a potential Problem Area? Yes ? Plot ID:
If needed, explain on reverse.
VEGETATION
Dominant Plant Soecies Stratum Indicator Dominant Plant Species Stratum Indicator
r
1.1A.e u;01 A-6Ar S?.YriC.1 t ? _-O-If ?S LKG 3.O
2191.ov.1r.. fGLc-7 `O
3. i ev.w- w?4=. =cp. -_ q«r? 3?:b Fctt . 3 '0 9._- ---- -- - -
10.--- - -
11.----

4.
-3 -- - ---
5.?
6.-- ---
7.-- --- - ---
--- -- - 14.--
15.-- ---
-
8.-- - -- ---- --- ---
16.- --
--
Percent of Dominant Species that are OBL, FACW or FAC
(excluding FAC-).
Remarks: VJ 2 ?? O?n+p? if ?rJ t Uv? ! S . /?? G
HYDROLOGY
- Recorded Data (Describe in Remarks):
- Stream, Lake, or ride Gauge
- Aerial Photographs
?ther
- No Recorded Data Available Wetland Hydrology Indicators:
Primary Indicators:
_ Inundated
- Saturated in Upper 12 Inches
_ Water Marks
- Drift Lines
_ Sediment Deposits
Field Observations: _ Drainage Patterns in Wetlands
Secondary Indicators (2 or more required):
Depth of Surface Water. (in.) - Oxidized Root Channels in Upper 12 Inches

Z _ Water-Stained Leaves
Depth to Free Water in Pit: (in.) _ Local Soil Survey Data
_ FAC-Neutrat Test
'Depth to Saturated Soil: -(in.) - Other (Explain in Remarks)
a
Remarks: ?-?? cw?0+ NyP ?O C O g V ! s P T c3 1 pr25 Q'Y?.?
B2 Appendix B Blank and Example Data Forms
SOILS
Map Unit Name
(Series and Phase): Q j
Gt.S ?'??' d'S? 5"^"? 40"-? Drainage Class:
--
Taxonomy (Subgroup): Field Observations
1?o? ?e uG?y ?5 - Confirm Mapped Type? Yes No
Profile Description:
Depth Matrix Color Mottle Colors Mottle Abundance/ Texture, Concretions,
(inches) Horizon (Munsell Moist) (Munsell Moist) Size/Contrast Structure. etc.
0-7
Hydric Soil Indicators: f
_ Hstosol -Concretions
- Histic c Odor - High Organic Content in Surface Layer in Sandy Soils
-
Aquic idi Odor Moisture Organic Streaking in Sandy Soils
qu Regime Listed on Local )iydric Soils List
- Reducing Conditions - Listed on National Hydric Soils List
- Gleyed or LovrChroma Colors - Other (Explain in Remarks)
Remarks: W 2. f• I a.-, j 5 O -L 4 5 , v--C r..j 0 o -e-'-Q -
WETLAND DETERMINATION
Hydrophytic Vegetation Present? ® No (Circle) (Circle)
Wetland Hydrology Present? Yes QE)
Hydric Soils Present? Yes 14z? Is this Sampling Point Within a Wetland? Yes
Remarks: 'v A `0 n
^.Q-4L. nJo
?4re. Sc.r.?
Approved by HQUSACE 3/92
Appendix B Blank and Example Data Forms B3
Phone Conversation Record
Talked with:

r \¢.vu¢? Date:

/1// / ??20 ?o Time:

l D ; ea
PM
of: National Marine Fisheries Phone # : [phone]
Re: Filling 1a(9 3 sq. ft. of 404 wetlands under NWP in County.
1 placed Call Pa Called
My Message Reply
Party's Message Reply
d
Action or Follow Up Necessary
Refer to: sl2 12 S -7 File #
Signed:
U 00
Phone Conversation Record
Talked with: Date: Time:
A/ PM
of: State Historic Preservation Office Phone # : [phone]
Re: Filling sq. ft. of 404 wetlands under NWP -? in P / County.
I placed Call Party Called
My Message Reply
Party's Message Reply

Action or Follow Up Necessary
Refer to: 59 /;Z5--7 File #:
Signed:
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®() 1546

DEC 1 4 2000
DWQ ID: CORPS ACTION ID:
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #) 14
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1. NOTIFICATION TO THE CORPS OF ENGINEERS
2. APPLICATION FOR SECTION 401 CERTIFICATION
3. COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT
SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THE APPROPRIATE FIELD
OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SHEET). SEVEN (7)
COPIES MUST BE SENT TO THE NC DIVISION OF WATER QUALITY
ATTN: JOHN DORNEY, 4401 REEDY CREEK ROAD, RALEIGH, NC
27607. PLEASE PRINT OR TYPE.
1. OWNER'S NAME: NCDOT
2. MAILING ADDRESS: P.O. BOX 1587
SUBDIVISION NAME:
CITY: GREENVILLE STATE: N.C. ZIP CODE: 27835
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
SR 1257 Pitt County
3. TELEPHONE NUMBER: (HOME) (WORK) 252-830-3490
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
Jay Johnson, NCDOT Division 2 Environmental Officer.
rn
C) -G
m
.< m
m z
CJ --i
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC MAP
OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: Pitt - NEAREST TOWN: Bruce
USGS TOPO Greenville NW Quadrangle Lat: 77 29 08 Long: 35 39 25
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ECT.) SR 1257 Cottondale road
6. IMPACTED OR NEAREST STREAM/RIVER: Lawrence Run Creek RIVER BASIN: Tar-Pam
? (a) IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER, (SA), HIGH
QUALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW), WATER SUPPLY (WS-I
OR WS-II)? YES ? NO x IF YES, EXPLAIN:
(b) IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES [_? NO x
(c) IF THE PROJECT IS LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR LIST OF
COASTAL COUNTIES), WHAT IS THE LAND USE PLAN (LUP) DESIGNATION? N/A
(a) HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROJECT? YES F? NO x IF YES, PROVIDE ACTION I.D. NUMBER OF PREVIOUS PERMIT AND
ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401 CERTIFICATION):
(b) ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE FUTURE?
YES F-j NO x IF YES, DESCRIBE ANTICIPATED WORK:
9. (a) ESTIMATED TOTAL NUMBERS OF ACRES IN TRACT OF LAND: N/A
(b) ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE: N/A
10. (a) NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: .17 EXCAVATION:
FLOODING: OTHER :
DRAINAGE : TOTAL ACRES TO BE IMPACTED:. 17
(b) (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED,
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION:
LENGTH BEFORE: FT AFTER: FT
WIDTH BEFORE (based on normal high water contours): FT
AVERAGE DEPTH BEFORE: 1 FT AFTER: 1 FT
(b) (2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL: X
CHANNEL EXCAVATION: X CONSTRUCTION OF A DAM/FLOODING:
OTHER:
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
DRAINING TO THE POND? WHAT IS THE EXPECTED POND SURFACE AREA?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT TO BE USED? (ATTACH PLANS; 81/2 BY 11 DRAWINGS ONLY)
Grade, Base, and Pave road SR 1257 to end. Realign 1257
13. PURPOSE OF PROPOSED WORK: To widen and pave SR 1257
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS)
There are wetlands on the realignment section of road. Onlv filline the areas needed to facilitate the new
road and safe shoulder slope.
15. YOU ARE REQUIRED TO CONTACT THE US FISH AND WILDLIFE SERVICE AND/OR
NATIONAL MARINE FISHERIES SERVICE REGARDING THE PRESENCE OF ANY FEDERALLY
LISTED OR PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL
HABITAT IN THE PERMIT AREA THAT MAY BE AFFECTED BY THE PROPOSED PROJECT.
DATE CONTACTED: 11/16/2000
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) REGARDING THE PRESENCE OF HISTORIC PROPERTIES IN THE PERMIT AREA
WHICH MAY BE AFFECTED BY THE PROPOSED PROJECT. DATE CONTACTED 11/16/2000.
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OT THE USE OF PUBLIC
(STATE) LAND? YES ® NO F-1 (IF NO, GO TO 16)
(a) IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIRONMENTAL
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA
ENVIRONMENTAL POLICY ACT? YES [:] NO
(b) IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE YES F? NO
IF ANSWER 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE STATE
CLEARINGHOUSE WITH THE NORTH CAROLINA ENVIRONMENTAL POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS BAGGETT, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 WEST JONES STREET, RALEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF PROPOSED
ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OF FILL MATERIAL INTO
WETLANDS:
(a) WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, LAKES, AND
PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 18, 21, 26, 29, AND 38).
ALL STREAM (INTERMITTENT AND PERMANENT) ON THE PROPERTY MUST BE SHOWN ON
THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS 50 FEET OF 1 INCH EQUALS 100 FEET
OF THEIR EQUIVALENT.
(b) IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED BY
PRODUCT.
(c) IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA SHEETS
RELEVANT TO THE PLACEMENT OF THE DELINEATION LINE.
(d) ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
(e) WHAT IS LAND USE OF SURROUNDING PROPERTY? Residential/Agriculture
(fl IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL? N/A
SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE US MAY NOT BE IMPACTED PRIOR TO:
1. ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2. EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF WATER QUALITY
CERTIFICATION, AND
3. (IN THE TWENTY COASTAL COUNTIES ONLY), A LETTER FROM THE NORTH
CAROLINA DIVISION OF COASTAL MANAGEMENT STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLINA COASTAL MANAGEMENT
PROGRAM,
OWNER'S/AGENT'S SIGNATURE DATE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED).
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DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Delineation Manual)
Project/Site: -_? le ? 2 -7-?-___ _ Date: 1 r _
Applicant/Owner: County- P1 ff'
--
Investigator: State: N •e. _-
Do Normal Circumstances exist on the site? <Z& No Community ID:
Is the site significantly disturbed (Atypical Situation)? Yes ctt) Transect ID:
Is the area a potential Problem Area? Yes Plot ID:
If needed, explain on reverse.
VEGETATION
Do pant Plant Species Stratum Indicator Dominant Plant Species Stratum Indicator
1 1"y,a?a...,bs ;;ILw 0 v 5'07. Fc? c 3-- 9. - --

2. -
3.
lan J14c 12 it xe?..?11
Y_--

5.- _ 13.
6. -- --- - -- - 14.--- -

7.- -
---- -- --
15. ---

8.
- ---- ---- -
16.- ---
--
Percent of Dominant Species that are OBL, FACW or FAC
(excluding FAC-).
Remarks: ?, 2 l 1/G C, r 5 P4 C-
HYDROLOGY
- Recorded Data (Describe in Remarks):
_ Stream, Lake, or Tide Gauge
Aerial Photographs
ther
-orded Data Available Wetland Hydrology Indicators:
Primary Indicators:
_ Inundated
- Saturated in Upper 12 Inches
_ Water Marks
_ Drift Lines
- Sediment Deposits
Field Observations: - Drainage Patterns in Wetlands

- Secondary Indicators (2 or more required):
Depth of Surface Water. ` (in.) - Oxidized Root Channels in Upper 12 Inches
- Water-Stained Leaves
Depth to Free Water in Pit: ? (in.) - Local Soil Survey Data
- FAC-Neutral Test
Depth to Saturated Soil: -(in.) - Other (Explain in Remarks)
®
Remarks: ?^? ?
p(v d ?o q ?/ j s ?Jv-G g c?.n
Y
B2 Appendix B Blank and Example Data Forms
SOILS
Map Unit Name ?_ 0
(Series and Phase): ! a-5
Draina
e Cl

/
1^
T
S
b
a<
-
41 g
ass:
Field Observations
)
axonomy (
u
group):
y
'
-
. t?
? Confirm Mapped Type? Yes No
Profile Descriotion-
Depth Matrix Color
(inches) Horizon (Muuns
ell Moist) ( Mottle Colors Mottle Abundance/ Texture, Concretions,
Munsell Moist) Si
/C
ze
ontrast Structure, etc,
s
Hydric Soil Indicators:
41
Histosol _ C retions
Histic don
Sulfidic Odor - gh Organic Content in Surface Layer in Sandy Soils
_ Organic Streaking in Sandy Soils
Ag4ic Moisture Regime =?biSfed on Local Hydric Soils List
%- TE ducing Conditions -kilted on National Hydric Soils List
1?Gleyed or Low-Chroma Colors - Other (Explain in Remarks)
Remarks: INc? .`?c s c? t.?? ??eSQ-v?
WETLAND DETERMINATION
Hydrophytic Vegetation Present? ® No (Circle) (Circle)
Wetland Hydrology Present? inNo
Hydric Soils Present? No Is this Sampling Point Within a Wetland? Ig No
Remarks:
Approved by HQUSACE 3192
Appendix B Blank and Example Data Forms B3

DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Delineation Manual)
Project/Site: S2 12 S 7 Date: I1 i o
Applicant/Owner: RkjZ)QL_ County: f -
Investigator:?r„? _ State:
Do Normal Circumstances exist on the site? c1rP No Community ID: _
Is the site significantly disturbed (Atypical Situation)? Yes (? Transect ID: _
Is the area a potential Problem Area? Yes Q?o::) Plot ID:
If needed, explain on reverse.) I
VEGETATION
Dominant Plant Species Stratum Indicator Dominant Plant Species Stratum In icat r
(
1.C,,?[bw?ST 21i 1?t -U_? ?s?c4 3'° 9.-- ---

2. -- -
110-
3.i cw? Jw4,.. cry. ----rrr 307.
faG . g?P
11._-_ -

4. Sm

O ---
5. GvbuS S.O. -- ?? i=es 3. 0 13.
-
6.-- - - -
14.

8.--- -- - -- ---
--- ----- --- --- - -
16.- - - --
Percent of Dominant Species that are OBL, FACW or FAC
(excluding FAC-).
---------------
------
Remarks: Vv e-?t Ov?.? If 2cJ L'? 'CI 4" ! 5 v e <
HYDROLOGY
- Recorded Data (Describe in Remarks):
- Stream, Lake, or Tide Gauge
_ Aerial Photographs
/Other
No Recorded Data Available Wetland Hydrology Indicators:
Primary Indicators:
- Inundated
- Saturated in Upper 12 Inches
- Water Marks
_ Drift Lines
- Sediment Deposits
Field Observations: _ Drainage Patterns in Wetlands
Secondary Indicators (2 or more required):
Depth of Surface Water. 1 (in.) - Oxidized Root Channels in Upper 12 Inches

> la _ Water-Stained Leaves
Depth to Free Water in Pit: (in.) - Local Soil Survey Data
_ FAC-Neutral Test
Depth to Saturated Soil: l "Z (in.) - Other (Explain in Remarks)
Remarks: w^`? ?cw?0+ VO?pgt/ f s /Jc9" ?rE.t?,?
B2 Appendix B Blank and Example Data Forms
SOILS
Map Unit Name ,t?? ,? _ 0 , 1
(Series and Phase): /' `?4hl? ADC GLS N ??? ?? s 1 oa..? Drainage Class:
--
r -
f
Taxonomy (Subgroup): - Field Observations
LQ?r_ts - Confirm Mapped Type? Yes No
Profile Description:. '
Depth Matrix Color
(inches)
Horizon (Munsell Moist) Mottle Colors Mottle Abundance/ Texture. Concretions,

(Munsell Moist) Size/Contrast St
ructure etc.

/
0-7

Hydric Soil Indicators: t
- Histosol - Concretions
- Histic Epipedon
- Sulfidic Odor - High Organic Content in Surface Layer in Sandy Soils
- Organic Streaking in Sandy Soils
- Aquic Moisture Regime Listed on Local Hydric Soils List
- Reducing Conditions - Listed on National Hydric Soils List
- Gleyed or LoarChroma Colors - Other (Explain in Remarks)
Remarks: (/?f Q ?- ar?? s e 4 S G
WETLAND DETERMINATION
Hydrophytic Vegetation Present? ® No (Circle) (Circle)
Wetland Hydrology Present? Yes
Hydric Soils Present? Yes AFL) Is this Sampling Point Within a Wetland? Yes
Remarks:
/j o ? L?-r C-+ l ua...
Approved by HQUSACE 3/92
Appendix B Blank and Example Data Forms B3
Phone Conversation Record
Talked with: Date: Time:
PM
Of: National Marine Fisheries Phone*: 252-728-5090
Re: Filling ja(q- sq. ft. of 404 wetlands under NWP ?T in Pt County.
I placed Call Pa Called
My Message Reply
Party's Message Reply
Action or Follow Up Necessary
Refer to: Ste 125-7 File #:
Signed:
U 00
Phone Conversation Record
Talked with: Date: Time:

S2c??w-T PM
Of: State Historic Preservation Office Phone # : [phone]
Re: Filling__Z2&3 sq. ft. of 404 wetlands under NWP in P ! -ff County.
I placed Call Party Called
My Message Reply
Party's Message Reply
Z)o rod' «?-cl ?sj r eats u.? s I -

Action or Follow Up Necessary
cg's--?---?
Refer to: 59 /a2 5"-7 File #
Signed:
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Op1546
DWQ ID: CORPS ACTION ID:

DEC 1 4 2?0

fir.. ..._.._.,...._.
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #) 14
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1. NOTIFICATION TO THE CORPS OF ENGINEERS
2. APPLICATION FOR SECTION 401 CERTIFICATION
3. COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT
SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THE APPROPRIATE FIELD
OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SHEET). SEVEN 7
COPIES MUST BE SENT TO THE NC DIVISION OF WATER QUALITY
ATTN: JOHN DORNEY, 4401 REEDY CREEK ROAD, RALEIGH, NC
27607. PLEASE PRINT OR TYPE.
1. OWNER'S NAME: NCDOT
2. MAILING ADDRESS: P.O. BOX 1587
SUBDIVISION NAME:
CITY: GREENVILLE STATE: N.C. ZIP CODE: 27835
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
SR 1257 Pitt County
3. TELEPHONE NUMBER: (HOME) (WORK) 252-830-3490
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
Jay Johnson, NCDOT Division 2 Environmental Officer.
rrri
C7 -G
m Fz
C f T'7
m z
C7 --i
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC MAP
OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: Pitt - NEAREST TOWN: Bruce
USGS TOPO Greenville NW Quadrangle Lat: 77 29 08 Long: 35 39 25
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ECT.) SR 1257 Cottondale road
6. IMPACTED OR NEAREST STREAM/RIVER: Lawrence Run Creek RIVER BASIN: Tar-Pam
? (a) IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER, (SA), HIGH
QUALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW), WATER SUPPLY (WS-I
OR WS-II)? YES ? NO x IF YES, EXPLAIN:
(b) IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES ? NO x
(c) IF THE PROJECT IS LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR LIST OF
COASTAL COUNTIES), WHAT IS THE LAND USE PLAN (LUP) DESIGNATION? N/A

(a) HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROJECT? YES ? NO x IF YES, PROVIDE ACTION I.D. NUMBER OF PREVIOUS PERMIT AND
ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401 CERTIFICATION):
(b) ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE FUTURE?
YES ? NO x IF YES, DESCRIBE ANTICIPATED WORK:
9. (a) ESTIMATED TOTAL NUMBERS OF ACRES IN TRACT OF LAND: N/A
(b) ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE: N/A
10. (a) NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: .17 EXCAVATION:
FLOODING: OTHER :
DRAINAGE : TOTAL ACRES TO BE IMPACTED:. 17
(b) (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED,
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION:
LENGTH BEFORE: FT AFTER: FT
WIDTH BEFORE (based on normal high water contours): FT
AVERAGE DEPTH BEFORE: 1 FT AFTER: 1 FT
(b) (2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL: X_
CHANNEL EXCAVATION: X_ CONSTRUCTION OF A DAM/FLOODING:
OTHER:
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
. DRAINING TO THE POND? WHAT IS THE EXPECTED POND SURFACE AREA?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT TO BE USED? (ATTACH PLANS; 81/2 BY 11 DRAWINGS ONLY)
Grade, Base, and Pave road SR 1257 to end. Realign 1257
13. PURPOSE OF PROPOSED WORK: To widen and pave SR 1257
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS)
There are wetlands on the realignment section of road. Only fillins the areas needed to facilitate the new
road and safe shoulder slope.
15. YOU ARE REQUIRED TO CONTACT THE US FISH AND WILDLIFE SERVICE AND/OR
NATIONAL MARINE FISHERIES SERVICE REGARDING THE PRESENCE OF ANY FEDERALLY
LISTED OR PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL
HABITAT IN THE PERMIT AREA THAT MAY BE AFFECTED BY THE PROPOSED PROJECT.
DATE CONTACTED: 11/16/2000
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) REGARDING THE PRESENCE OF HISTORIC PROPERTIES IN THE PERMIT AREA
WHICH MAY BE AFFECTED BY THE PROPOSED PROJECT. DATE CONTACTED 11/16/2000.
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OT THE USE OF PUBLIC
(STATE) LAND? YES ® NO ? (IF NO, GO TO 16)
(a) IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIRONMENTAL
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA
ENVIRONMENTAL POLICY ACT? YES ? NO
(b) IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE YES ? NO
IF ANSWER 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE STATE
CLEARINGHOUSE WITH THE NORTH CAROLINA ENVIRONMENTAL POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS BAGGETT, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 WEST JONES STREET, RALEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone]. R
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF PROPOSED
ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OF FILL MATERIAL INTO
WETLANDS:
(a) WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, LAKES, AND
PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 18, 21, 26, 29, AND 38).
ALL STREAM (INTERMITTENT AND PERMANENT) ON THE PROPERTY MUST BE SHOWN ON
THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS 50 FEET OF 1 INCH EQUALS 100 FEET
OF THEIR EQUIVALENT.
(b) IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED BY
PRODUCT.
(c) IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA SHEETS
RELEVANT TO THE PLACEMENT OF THE DELINEATION LINE.
(d) ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
(e) WHAT IS LAND USE OF SURROUNDING PROPERTY? Residential/Agriculture
(f) IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL? N/A
SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE US MAY NOT BE IMPACTED PRIOR TO:
1. ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2. EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF WATER QUALITY
CERTIFICATION, AND
3. (IN THE TWENTY COASTAL COUNTIES ONLY), A LETTER FROM THE NORTH
CAROLINA DIVISION OF COASTAL MANAGEMENT STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLINA COASTAL MANAGEMENT
PROGRAM,
d/??
OWNER'S/AGENT'S SIGNATURE DATE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED).
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EDWARD R M ROW
I TRANSMIrrlb ?I ?IOfi OF ' i
I VOICE OF-AI MCA_
Copyright (C) 1997, Maptech, Inc
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DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Delineation Manual)
Project/Site:
? Date:
oZ
Applicant/Owner: NCt? County: eel ff
Investigator: State: N •e.
Do Normal Circumstances exist on the site? <Z& No Community ID: _
Is the site significantly disturbed (Atypical Situation)? Yes c1f) Transect ID:
Is the area a potential Problem Area? Yes Plot ID:
If needed, explain on reverse.
VEGETATION
D-o'pinant Plant Species Stratum Indicator Dominant Plant Soecies Stratum Indicator
OV 5'o7. Ak-C- 3-• 9. --

o F0.a 3 °
2. (/ ki? -
1o._-- - -
? - - - -
5.-- - - - -- 13..-

6.-- ----- ---- ---
7._ - -
14._ - -- ---
15.

8.-- - - ---- --- _
16.- -
--
Percent of Dominant Species that are OBL, FACW or FAC
(excluding FAC- .
->6-^
/
Remarks: 5 +^e S t?iM ^?
HYDROLOGY
- Recorded Data (Describe in Remarks):
_ Stream, Lake, or Tide Gauge
Aerial Photographs
_-,Other
No Recorded Data Available Wetland Hydrology Indicators:
Primary Indicators:
_ Inundated
_ Saturated in Upper 12 Inches
- Water Marks
_ Drift Lines
- Sediment Deposits
Field Observations: - Drainage Patterns in Wetlands
Secondary Indicators (2 or more required):
Depth of Surface Water: -? (in.) - Oxidized Root Channels in Upper 12 Inches
- Water-Stained Leaves
Depth to Free Water in Pit: ? (in.) - Local Soil Survey Data
_ FAC-Neutral Test
Depth to Saturated Soil: (in.) - Other (Explain in Remarks)
Remarks:

B2 Appendix B Blank and Example Data Forms
SOILS
Map Unit Name
(Series and Phase): -et-5 J-?t 1p q- - Drainage Class:
^ Field Observations
Taxonomy (Subgroup): 1 )a, C- b fC110 !IN-14"-C6 J--- Confirm Mapped Type? Yes No
Profile Description:
Depth Matrix Color Mottle Colors Mottle Abundance/ Texture, Concretions,
(inches) Horizon (Munsell Moist) (Munsell Moist) Size/Contrast 'Structure. etc.
Hydric Soil Indicators:
All
- Histosol - C retions
Histic Epipedon _-High Organic Content in Surface Layer in Sandy Soils
- Sulfidic Odor _ Organic Streaking in Sandy Soils
AVic Moisture Regime = elled on Local Hydric Soils List.
TE ducing Conditions %-listed on National Hydric Soils List
::; leyed or Low-Chroma Colors - Other (Explain in Remarks)
Remarks: (N l aM? .°jo 5 ?V^2.? 1? ??E-'
WETLAND DETERMINATION
Hydrophytic Vegetation Present? ® No (Circle) (Circle)
Wetland Hydrology Present? No
Hydric Soils Present? es No Is this Sampling Point Within a Wetland? . V No
/
Remarks: 'W
Approved by HOUSACE 3/92
Appendix B Blank and Example Data Forms B3

DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Delineation Manual)
Project/Site: S 2 1 Z 5 Date: 11 i o c,
Applicant/Owner: ktt )QL
- County: 11;'t6
Investigator: ?wv ?o mow. - State: AJ.L.. -
Do Normal Circumstances exist on the site? clgP No Community ID:
Is the site significantly disturbed (Atypical Situation)? Yes (T:) Transect ID:

Is the area a potential Problem Area? Yes t? _
Plot ID:
If needed, explain on reverse.) I
VEGETATION
Dominant Plant Species Stratum Indicator Dominant Plant Soecies Stratum Indicator
1. C//tty?l?.?bw?5,,??tf _?J?!?/ca 3•° s._- ---
10-
3.?i
4.?tlt?giG 13?r„" ' -- -_ 1??• -E5-.4 3 • ° 12.
--

8.--- -- --- ---- ---- 16.- - -
-- -- -
Percent of Dominant Species that are 08L, FACW or FAC
(excluding FAG).
-
------
Remarks: (/J??-C AM? if 2c? +C .?ov?I Cn.? t S ?v G 7 ?-
HYDROLOGY
- Recorded Data (Describe in Remarks):
- Stream, Lake, or Tide Gauge
- Aerial Photographs
/Other
- No Recorded Data Available Wetland Hydrology Indicators:
Primary Indicators:
_ Inundated
- Saturated in Upper 12 Inches
- Water Marks
_ Drift Lines
- Sediment Deposits
Field Observations: _ Drainage Patterns in Wetlands
Secondary Indicators (2 or more required):
Depth of Surface Water. -"? (in.) - Oxidized Root Channels in Upper 12 Inches

Z - Water-Stained Leaves
Depth to Free Water in Pit: (in.) - Local Soil Survey Data
_ FAC-Neutral Test
Depth to Saturated Soil: (in.) - Other (Explain in Remarks)
Remarks:
B2 Appendix B Blank and Example Data Forms
SOILS
Map Unit Name
(Series and Phase): IOC D_-GLS N ??' 3a??c s« ae..-? Drainage Class:
-?
Taxonomy (Subgroup): ??% (' J?&Ie u?/ G?yI ?tS Field Observations
Confirm Mapped Type? Yes No
Profile Description: '
Depth . Matrix Color Mottle Colors Mottle Abundance/ Texture, Concretions,
(inches) Horizon (Munsell Moist) (Munsell Moist) Size/Contrast Structure. etc,
0-7 Hydric Soil Indicators: f
- Histosol - Concretions
- Histic Epipedon - High Organic Content in Surface Layer in Sandy Soils
- Sulfidic Odor - Organic Streaking in Sandy Soils
Aquic Moisture Regime Listed on Local Hydric Soils List
- Reducing Conditions - Listed on National Hydric Soils List
- Gleyed or Low-Chroma Colors Other (Explain in Remarks)
Remarks: (N 2 ?- Q„?? s 0-L
5 c? WETLAND DETERMINATION

Hydrophytic Vegetation Present? (G No (Circle) (Circle)
Wetland Hydrology Present? Yes
Hydric Soils Present? Yes I® Is this Sampling Point Within a Wetland? Yes ®o
Remarks: Aj 0 n tN l rlw.?CX C? /( ?rt
, -"
Approved by HQUSACE 3192
Appendix B Blank and Example Data Forms B3
Phone Conversation Record
Talked with:
pr r Date:
/1// l 1;2z, ,-o Time:
10,'00
PM
Of: National Marine Fisheries Phone # : [phone]
Re: Filling 12 sq. ft. of 404 wetlands under NWP in Pl ? ` County.
I placed Call ?Pa Called
My Message Reply
Party's Message Reply
D?
Action or Follow Up Necessary
N'o vt,e.?
Refer to: S le 1 2 5-7 File #:
Signed:
U 0p
Phone Conversation Record
Talked with: Date: Time:

Szc?e? PM
Of: State Historic Preservation Office Phone # : [phone]
Re: Filling__Y2&3 sq. ft. of 404 wetlands under NWP in P ! County.
I placed Call Party Called
My Message Reply
Party's Message Reply
0%o ?.cl s? rte. °s u.? ? -

Action or Follow Up Necessary
Refer to: 59 /a'2 5-7 File #:
Signed:
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DEC 4 200
001546
DWQ ID: CORPS ACTION ID:

NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #) 14
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1. NOTIFICATION TO THE CORPS OF ENGINEERS m D
2. APPLICATION FOR SECTION 401 CERTIFICATION C-) -<
3. COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT m Hz
SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THE APPROPRIATE FIELD m Z
OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SHEET). SEVEN (7) --i
COPIES MUST BE SENT TO THE NC DIVISION OF WATER QUALITY,
ATTN: JOHN DORNEY, 4401 REEDY CREEK ROAD, RALEIGH, NC
27607. PLEASE PRINT OR TYPE.
1. OWNER'S NAME: NCDOT
2. MAILING ADDRESS: P.O. BOX 1587
SUBDIVISION NAME:
CITY: GREENVILLE STATE: N.C. ZIP CODE: 27835
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
SR 1257 Pitt County
3. TELEPHONE NUMBER: (HOME) (WORK) 252-830-3490
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
Jay Johnson, NCDOT Division 2 Environmental Officer.
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC MAP
OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: Pitt - NEAREST TOWN: Bruce
USGS TOPO Greenville NW Quadrangle Lat: 77 29 08 Long: 35 39 25
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ECT.) SR 1257 Cottondale road
6. IMPACTED OR NEAREST STREAM/RIVER: Lawrence Run Creek RIVER BASIN: Tar-Pam
? (a) IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER, (SA), HIGH
QUALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW), WATER SUPPLY (WS-I
OR WS-II)? YES ? NO x IF YES, EXPLAIN:
(b) IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES ? NO x
(c) IF THE PROJECT IS LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR LIST OF
COASTAL COUNTIES), WHAT IS THE LAND USE PLAN (LUP) DESIGNATION? N/A
(a) HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROJECT? YES ? NO x IF YES, PROVIDE ACTION I.D. NUMBER OF PREVIOUS PERMIT AND
ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401 CERTIFICATION):
(b) ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE FUTURE?
YES ? NO x IF YES, DESCRIBE ANTICIPATED WORK:
9. (a) ESTIMATED TOTAL NUMBERS OF ACRES IN TRACT OF LAND: N/A
(b) ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE: N/A
10. (a) NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: .17 EXCAVATION:
FLOODING: OTHER :
DRAINAGE : TOTAL ACRES TO BE IMPACTED:. 17
R
(b) (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED,
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION:
LENGTH BEFORE: FT AFTER: FT
WIDTH BEFORE (based on normal high water contours): FT
AVERAGE DEPTH BEFORE: 1 FT AFTER: 1 FT
(b) (2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL: X_
CHANNEL EXCAVATION: X_ CONSTRUCTION OF A DAM/FLOODING:
OTHER:
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
DRAINING TO THE POND? WHAT IS THE EXPECTED POND SURFACE AREA?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT TO BE USED? (ATTACH PLANS; 81/2 BY 11 DRAWINGS ONLY)
Grade, Base, and Pave road SR 1257 to end. Realign 1257
13. PURPOSE OF PROPOSED WORK: To widen and pave SR 1257
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS)
There are wetlands on the realienment section of road. Onlv filling the areas needed to facilitate the new
road and safe shoulder slope.
15. YOU ARE REQUIRED TO CONTACT THE US FISH AND WILDLIFE SERVICE AND/OR
NATIONAL MARINE FISHERIES SERVICE REGARDING THE PRESENCE OF ANY FEDERALLY
LISTED OR PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL
HABITAT IN THE PERMIT AREA THAT MAY BE AFFECTED BY THE PROPOSED PROJECT.
DATE CONTACTED: 11/16/2000
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) REGARDING THE PRESENCE OF HISTORIC PROPERTIES IN THE PERMIT AREA
WHICH MAYBE AFFECTED BY THE PROPOSED PROJECT. DATE CONTACTED 11/16/2000.
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OT THE USE OF PUBLIC
(STATE) LAND? YES ® NO F? (IF NO, GO TO 16)
(a) IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIRONMENTAL
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA
ENVIRONMENTAL POLICY ACT? YES 0 NO
(b) IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE YES [] NO
IF ANSWER 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE STATE
CLEARINGHOUSE WITH THE NORTH CAROLINA ENVIRONMENTAL POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS BAGGETT, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 WEST JONES STREET, RALEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF PROPOSED
ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OF FILL MATERIAL INTO
WETLANDS:
(a) WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, LAKES, AND
PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 18, 21, 26, 29, AND 38).
ALL STREAM (INTERMITTENT AND PERMANENT) ON THE PROPERTY MUST BE SHOWN ON
THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS 50 FEET OF 1 INCH EQUALS 100 FEET
OF THEIR EQUIVALENT.
(b) IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED BY
PRODUCT.
(c) IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA SHEETS
RELEVANT TO THE PLACEMENT OF THE DELINEATION LINE.
(d) ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
(e) WHAT IS LAND USE OF SURROUNDING PROPERTY? Residential/Agriculture
(f) IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL? N/A
SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE US MAY NOT BE IMPACTED PRIOR TO:
1. ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2. EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF WATER QUALITY
CERTIFICATION, AND
3. (IN THE TWENTY COASTAL COUNTIES ONLY), A LETTER FROM THE NORTH
CAROLINA DIVISION OF COASTAL MANAGEMENT STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLINA COASTAL MANAGEMENT
PROGRAM,
OWNER'S/AGENT'S SIGNATURE DATE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED).
y- ,
( gyp... Idle a - a ??n? ?CBPri
r. o ? ?°,d` r ? ? i t ? ? ?i L 3 l ?`-`? ?y? -' f ? { \ ? ?i Al,;? ?,r '`- - `ar ? ?-^,_,_._='-.1..?-.-..--'.a.'•
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g TRANSMYMNG,V' Tt0N OF 1 y
II # VOICE OF!AMIERICA .. _ _ 1
Coovright (C) 1997, Maptech, Inc
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DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Delineation Manual)
Project/Site: Date:
? -
Applicant/Owner: N C Do County: _ t
Investigator: ?0.? e(•??.. o,., State: N •e• -
Do Normal Circumstances exist on the site? (ZO No Community ID:
Is the site significantly disturbed (Atypical Situation)? Yes ct§ Transect ID: -
Is the area a potential Problem Area? Yeso Plot ID: ?-
(If needed, explain on reverse.
VEGETATION
QQ9nant Plant Species Stratum Indicator Dominant Plant Species Stratum Indicator
1,?lelcti....low?•r• S ?y??(?;?/?w 0 v Sot ??? 3•• s. -- -

5.
-
-- - 13.
-
-
6.- ------
7. -
-- --
----- ---
- - -- --- - - -
14.--- ---
15.---

8.- -- -

--- ---
---- -
16.
16. --
-- -- -
Percent of Dominant Species that are OBL, FACW or FAC
(excluding FAC-).
Remarks: ?1 Q l ?E C 1 5 LQ y,e s ?i}? ?-
HYDROLOGY
- Recorded Data (Describe in Remarks):
- Stream, Lake, or Tide Gauge
Aerial Photographs
er
- No Recorded Data Available Wetland Hydrology Indicators:
Primary Indicators:
_ Inundated
_ Saturated in Upper 12 Inches
_ Water Marks
- Drift Lines
_ Sediment Deposits
Field Observations: _ Drainage Patterns in Wetlands

- Secondary Indicators (2 or more required):
Depth of Surface Water: ? (in.) - Oxidized Root Channels in Upper 12 Inches
_ Water-Stained Leaves
Depth to Free Water in Pit: ? (in.) - Local Soil Survey Data
_ FAC-Neutral Test
Depth to Saturated Soil: (in.) - Other (Explain in Remarks)
Remarks: wla N
p( t,-DL. t/ j S ?JrG gs?.n
Y
B2 Appendix B Blank and Example Data Forms
SOILS
Map Unit Name
(Series and Phase): 1`
aina
D
Cl

?//
Taxonomy (Subgroup): -/)or G 4¢g r
ge
ass:
Field Observations
t?J C
f
on
irm Mapped Type? Yes No
Profile Description:
Depth Matrix Color
finches) Horizon (Mu
(
nssell Moist) Mottle Colors Mottle Abundance/ Texture, Concretions,

Munsell Moist) Size/Cont
t
ras
Structure. etc.
?
? /
Hydric Soil Indicators:
t
Histosol
Histic don _ C retions
-nigh Organic Content in Surface Layer in Sandy Soils
_ Sulfidic Odor Organic Streaking in Sandy Soils
Agyic Moisture Regime fed on Local Hydric Soils List.
e?ducing Conditions
! 4isted on National Hydric Soils List
Z
Gleyed or Low-Chroma Colors _ Other (Explain in Remarks)
Remarks: w aM? go s a.y-?_ ??e
WETLAND DETERMINATION
Hydrophytic Vegetation Present? ® No (Circle) (Circle)
Wetland Hydrology Present? No
Hydric Soils Present? s No Is this Sampling Point Within a Wetland? ja No
Remarks: a "j
- G?- L ! Qi? ?.??? ?Y??
Hpprovea oy HQU5AGE 3/92
Appendix 5 Blank and Example Data Forms B3

DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Delineation Manual)
Project/Site: S12 1 2 5 7 Date: II ! o a
Applicant/Owner: kS. Q_r__ County: iP;
Investigator: State:
5?.
Do Normal Circumstances exist on the site? 46;P No Community ID:
Is the site significantly disturbed (Atypical Situation)? Yes ? Transect ID:
Is the area a potential Problem Area? Yes QQo) Plot ID:
If needed, explain on reverse.) I
VEGETATION
Dominant Plant Species Stratum Indicator Dominant Plant Species Stratum Indicator
1. C y_i?a b?,c ?T ?j ? l stc _S?_J_!y ? e-
2.1
Qc6?. iQ??ow... ?r5' fGLC-?`O
-- 9._- --- --
10.----- _
/
3. G? ? c.w+? Jay4.... cup.
4.?
tli?P?af1?.-
?7o fat . g?O _
11. -
p
6.-- - 14.

7.-- -
-- --
--- - - --
IS.

8. -- -

- ---- -- -

16.- -

Percent of Dominant Species that are OBL. FACW or FAC \
(excluding FAC-).
---
Remarks: Vj ?.L O?Mp? If 2 C (+?p,?CI lJtr? l S ?v C ??rv1
HYDROLOGY
- Recorded Data (Describe in Remarks):
- Stream, Lake, or Tide Gauge
- Aerial Photographs
Other
- No Recorded Data Available Wetland Hydrology Indicators:
Primary Indicators:
- Inundated
- Saturated in Upper 12 Inches
_ Water Marks
_ Drift Lines
_ Sediment Deposits
Field Observations: _ Drainage Patterns in Wetlands
Secondary Indicators (2 or more required):
Depth of Surface Water. (in.) - Oxidized Root Channels in Upper 12 Inches

2 Water-Stained Leaves
-
Depth to Free Water in Pit: (in.) - Local Soil Survey Data
_ FAC-Neutral Test
Depth to Saturated Soil: -;Iz (in.) - Other (Explain in Remarks)
Remarks: of ?ytt ?D t o g V 1 S "'Jot B2 Appendix B Blank and Example Data Forms

SOILS
Map Unit Name M I'
(Series and Phase): Jh -4-S ti"', ??_?_c 5 ea r-. Drainage Class: _
Taxonomy (Subgroup): >dl., t5 Field Observations
Confirm Mapped Type? Yes No
Profile Description, '
Depth Matrix Color Mottle Colors Mottle Abundance/ Texture, Concretions,
(inchesl Horizon (Munsell Moist) (Munsell Moist) Size/Contrast Structure. etc.
0-7
Hydric Soil Indicators: ;
- Histosol - Concretions
- Histic Epipedon - High Organic Content in Surface Layer in Sandy Soils
- Sulfidic Odor Organic Streaking in Sandy Soils
Aquic Moisture Regime Listed on Local tiydric Soils List
Reducing Conditions Listed on National Hydric Soils List
- Gleyed or Lov,,Ch//roma Colors - Other (Explain in Remarks)
Remarks:
WETLAND DETERMINATION
Hydrophytic Vegetation Present? ® No (Circle) (Circle)
Wetland Hydrology Present? Yes Q
Hydric Soils Present? Yes t® Is this Sampling Point Within a Wetland? Yes
Remarks: ? D ?-"l• (N'?' l GLa.+GC ? G?- G C ?Gt v-,p? y? ? ?? a?.c.-0.. ?.JO t`
Approved by HQUSACE 3192
Appendix :B Blank and Example Data Forms B3
Phone Conversation Record
Talked with: Date: Time:
PM
Of: National Marine Fisheries Phone # : [phone]
Re: Filling 7a?3 sq. ft. of 404 wetlands under NWP in PJ, County.
I placed Call FZ?j Party Called
My Message Reply
Party's Message Reply
d
Action or Follow Up Necessary
Refer to: .S se 12-5-7 File #
Signed:
U 00
Phone Conversation Record
Talked with: Date: Time:
PM
Of: State Historic Preservation Office Phone # : [phone]
Re: Filling __22&-S sq. ft. of 4o4 wetlands under NWP in P ( County.
I placed Call Party Called
My Message Reply
Party's Message Reply
s „?.., Ij r r?

Action or Follow Up Necessary Ij
v'r-sL?
Refer to: -7
5 R is s File #
Signed:
?o
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DEC 14 M
0(31546
DWQ ID: CORPS ACTION ID:

NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #) 14
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1. NOTIFICATION TO THE CORPS OF ENGINEERS
2. APPLICATION FOR SECTION 401 CERTIFICATION
3. COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT
SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THE APPROPRIATE FIELD
OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SHEET). SEVEN (7)
COPIES MUST BE SENT TO THE NC DIVISION OF WATER QUALITY,
ATTN: JOHN DORNEY, 4401 REEDY CREEK ROAD, RALEIGH, NC
27607. PLEASE PRINT OR TYPE.
1. OWNER'S NAME: NCDOT
2. MAILING ADDRESS: P.O. BOX 1587
SUBDIVISION NAME:
CITY: GREENVILLE STATE: N.C. ZIP CODE: 27835
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
SR 1257 Pitt County
3. TELEPHONE NUMBER: (HOME) (WORK) 252-830-3490
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
Jay Johnson, NCDOT Division 2 Environmental Officer.
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC MAP
OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: Pitt - NEAREST TOWN: Bruce
USGS TOPO Greenville NW Quadrangle Lat: 77 29 08 Long: 35 39 25
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ECT.) SR 1257 Cottondale road
6. IMPACTED OR NEAREST STREAM/RIVER: Lawrence Run Creek RIVER BASIN: Tar-Pam
? (a) IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER, (SA), HIGH
QUALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW), WATER SUPPLY (WS-I
OR WS-II)? YES F-1 NO x IF YES, EXPLAIN:
(b) IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES F-1 NO x
n ?
m ?
crn
m z
(c) IF THE PROJECT IS LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR LIST OF
COASTAL COUNTIES), WHAT IS THE LAND USE PLAN (LUP) DESIGNATION? N/A
(a) HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROJECT? YES ? NO x IF YES, PROVIDE ACTION I.D. NUMBER OF PREVIOUS PERMIT AND
ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401 CERTIFICATION):
(b) ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE FUTURE?
YES F? NO x IF YES, DESCRIBE ANTICIPATED WORK:
9. (a) ESTIMATED TOTAL NUMBERS OF ACRES IN TRACT OF LAND: N/A
(b) ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE: N/A
10. (a) NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: .17 EXCAVATION:
FLOODING: OTHER :
DRAINAGE : TOTAL ACRES TO BE IMPACTED:. 17
(b) (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED,
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION:
LENGTH BEFORE: FT AFTER: FT
WIDTH BEFORE (based on normal high water contours): FT
AVERAGE DEPTH BEFORE: 1 FT AFTER: 1 FT
(b) (2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL: X_
CHANNEL EXCAVATION: X_ CONSTRUCTION OF A DAM/FLOODING:
OTHER:
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
DRAINING TO THE POND? WHAT IS THE EXPECTED POND SURFACE AREA?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT TO BE USED? (ATTACH PLANS; 81/2 BY 11 DRAWINGS ONLY)
Grade, Base, and Pave road SR 1257 to end. Realign 1257
13. PURPOSE OF PROPOSED WORK: To widen and pave SR 1257
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS)
There are wetlands on the realignment section of road. Only filling the areas needed to facilitate the new
road and safe shoulder slope.
15. YOU ARE REQUIRED TO CONTACT THE US FISH AND WILDLIFE SERVICE AND/OR
NATIONAL MARINE FISHERIES SERVICE REGARDING THE PRESENCE OF ANY FEDERALLY
LISTED OR PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL
HABITAT IN THE PERMIT AREA THAT MAY BE AFFECTED BY THE PROPOSED PROJECT.
DATE CONTACTED: 11/16/2000
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) REGARDING THE PRESENCE OF HISTORIC PROPERTIES IN THE PERMIT AREA
WHICH MAYBE AFFECTED BY THE PROPOSED PROJECT. DATE CONTACTED 11/16/2000.
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OT THE USE OF PUBLIC
(STATE) LAND? YES ® NO ? (IF NO, GO TO 16)
(a) IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIRONMENTAL
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA
ENVIRONMENTAL POLICY ACT? YES ? NO
(b) IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE YES r-? NO
IF ANSWER 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE STATE
CLEARINGHOUSE WITH THE NORTH CAROLINA ENVIRONMENTAL POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS BAGGETT, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 WEST JONES STREET, RALEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone].
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF PROPOSED
ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OF FILL MATERIAL INTO
WETLANDS:
(a) WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, LAKES, AND
PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 18, 21, 26, 29, AND 38).
ALL STREAM (INTERMITTENT AND PERMANENT) ON THE PROPERTY MUST BE SHOWN ON
THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS 50 FEET OF 1 INCH EQUALS 100 FEET
OF THEIR EQUIVALENT.
(b) IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED BY
PRODUCT.
(c) IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA SHEETS
RELEVANT TO THE PLACEMENT OF THE DELINEATION LINE.
(d) ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
(e) WHAT IS LAND USE OF SURROUNDING PROPERTY? Residential/Agriculture
(fl IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL? N/A
SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE US MAY NOT BE IMPACTED PRIOR TO:
I . ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2. EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF WATER QUALITY
CERTIFICATION, AND
3. (IN THE TWENTY COASTAL COUNTIES ONLY), A LETTER FROM THE NORTH
CAROLINA DIVISION OF COASTAL MANAGEMENT STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLINA COASTAL MANAGEMENT
PROGRAM, (??Ll
OWNER'S/AGENT'S SIGNATURE DATE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED).
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?v
DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Delineation Manual)
Project/Site: -I r? 12 -7 Date: i I
Applicant/Owner: NCt?o _- County: Nlth
Investigator: ---- State: N •e.
Do Normal Circumstances exist on the site? <Z& No Community ID:
Is the site significantly disturbed (Atypical Situation)? Yes cj_ Transect ID:
Is the area a potential Problem Area? Yeso Plot ID:
If needed, explain on reverse.
VEGETATION
Do*nant Plant Species Stratum Indicator Dominant Plant Species Stratum Indicator
1 Z, j y ?6.,- (mow 0 d 5'07. /?wG 3-" s. -

3. Im ?Ilape k2 It xfib-- 'ilY

5.--- --
-946
---- --
12.-
13.-- -

6.
--- --- - -

-
14.------
7.-
8. - -
--- --- ---
15. -
16. ------
-
Percent of Dominant Species that are OBL, FACW or FAC
(excluding FAC-).
------------------------------
-a
l
Remarks: ??? e l I/E Jc S ya+? Q S Pity C-
HYDROLOGY
- Recorded Data (Describe in Remarks):
- Stream, Lake, or Tide Gauge
Aerial Photographs
der
No Recorded Data Available
.kf Wetland Hydrology Indicators:
Primary Indicators:
_ Inundated
- Saturated in Upper 12 Inches
- Water Marks
- Drift Lines
- Sediment Deposits
Field Observations: _ Drainage Patterns in Wetlands

- Secondary Indicators (2 or more required):
Depth of Surface Water: `
(in.) - Oxidized Root Channels in Upper 12 Inches
- Water-Stained Leaves
Depth to Free Water in Pit: 93 (in.) - Local Soil Survey Data
_ FAC-Neutral Test
Depth to Saturated Soil: (in.) - Other (Explain in Remarks)
Remarks: ?^? (r
p?vD ?/ j S
Lo ?JrC gsz
Y g
62 Appendix B Blank and Example Data Forms
SOILS
Map Unit Name
(Series and Phase): !? t
4L-5t
Draina
e Cl
{
?

^
Taxonomy (Subgroup):
-/IarG
- g
-
- _-
_
ass:
Field Observations
_ C- Confirm Mapped Type? Yes N
o
Profile Description;
Depth Matrix Color
(inches) Florizon (Munsell Moist) Mottle Colors Mottle Abundance/ Texture, Concretions,
(Munsell Moi
t)
s
Size/Contrast Structure, etc. _

Hydric Soil Indicators:
t
- Histosol
_ Histic d
on ?etions
- gh Organic Content in Surface
Layer in Sandy Soils
or
idic Odor .
Organic Streaking in Sandy Soils
q
AVic
Moisture Regime
?i
i fed on Local Hydric Soils List
RA?E Ed cl
ng Conditions
Z:-Gleyed or Low-Chroma Colors _-6isted on National Hydric Soils List
_ Other (Explain in Remarks)
Remarks: IN A.ti? -n (s ci.y-Q,? ?e? ?-v
WETLAND DETERMINATION
Hydrophytic Vegetation Present? ® No (Circle) (Circle)
Wetland Hydrology Present? No
Hydric Soils Present? No Is this Sampling Point Within a Wetland? (Q No
Remarks:
Approved by HQUSACE 3/92
Appendix B Blank and Example Data Forms B3
r?
DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Delineation Manual)
Project/Site: 52 1 Z S 7 Y_- --- __ Date: _11 i o4 _
Applicant/Owner: kq DQT--_
-- County: f i -
Investigator: ?w? State: AJ.C_.
Do Normal Circumstances exist on the site? daP No Community ID: M--_
Is the site significantly disturbed (Atypical Situation)? Yes (M:? Transect ID:

Is the area a potential Problem Area?
Yes (tEo:_-) _
Plot ID:
If needed, explain on reverse.) I
VEGETATION
Dominant Plant Species Stratum Indicator Dominant Plant Soecies Stratum Indicator
(
2.?C8b YlulOrJ... ??5? ?C 3.0 10.-- -

3.4M:?.,....1..?
4.?
11t?q,Y b?W.!V?_

_???_E 3 •0 - -

12.-- ----
p
5. Cv6,S 5 0. --
----?-X"-low 3.0 - ---
13. - -- -
6.- - - - 14.

7.--
8.-- -
--
-- --- ---
- ----- --- _ --
15.- _
16.- --
-- --
Percent of Dominant Species that are OBL, FACW or FAC
(excluding FAG).
--s
II
Remarks: vjQ LG1Mp? t
1lQGo?C1 lnr? l S ?? -' "^T?^
HYDROLOGY
- Recorded Data (Describe in Remarks):
- Stream, Lake, or Tide Gauge
_ Aerial Photographs
?ther
- No Recorded Data Available Wetland Hydrology Indicators:
Primary Indicators:
_ Inundated
- Saturated in Upper 12 Inches
_ Water Marks
_ Drift Lines
_ Sediment Deposits
Field Observations: _ Drainage Patterns in Wetlands
Secondary Indicators (2 or more required):
Depth of Surface Water: --? (in.) - Oxidized Root Channels in Upper 12 Inches

Z Water-Stained Leaves
_
Depth to Free Water in Pit: /
(in.) _ Local Soil Survey Data
_ FAC-Neutral Test
Depth to Saturated Soil: GZ (in.) - Other (Explain in Remarks)
Remarks: ?J?? l cw?Ot ?y??0 ?O J/ f S /?Tc7?f' prE'-3SZY??
B2 Appendix B Blank and Example Data Forms
SOILS
Map Unit Name ,y?
(Series and Phase): r/ `eGi 9 ?'??' Drainage Class:
-'
'
?
f T
Taxonomy (Subgroup): Field
-
Observations
be u d 1 s - Confirm Mapped Type? Yes No
Profile Descriotion '
Depth . . Matrix Color
(i
nches) Horizon (Munsell Moist) Mottle Colors Mottle Abundance/ Texture, Concretions,

((Munsell Moist) Size/Contrast St
ructure, etc,

/
0-7

Hydric Soil Indicators: t
- Histosol - Concretions
- Histic Epipedon
- Sulfidic Odor - FGgh Organic Content in Surface Layer in Sandy Soils
Organic Streaking in Sandy Soils
Aquic Moisture Regime
Reducing Conditions Listed on Local Hydric Soils List
Listed on National Hydric Soils List
- Gleyed or Low-Chroma Colors - Other (Explain in Remarks)
r
Remarks: w a ?- ? q„? ? s o L (t 5 0?
WETLAND DETERMINATION
Hydrophytic Vegetation Present? ® No (Circle) (Circle)
Wetland Hydrology Present? Yes
Hydric Soils Present? Yes I® Is this Sampling Point Within a Wetland? Yes ®°
Remarks: Aj 0 p1 L^lC-+ I4-&,C1 G? G C ?GC.v-q ,yi d --,a- 'o
Approved by HQUSACE 3/92
Appendix B Blank and Example Data Forms B3
Phone Conversation Record
Talked with:

N V `Q Y Date:

/1// t /j24paro Time:

! t7 : 027
PM
Of: National Marine Fisheries Phone*: 252-728-5090
Re: Filling _12(o- sq. ft. of 404 wetlands under NWP in County.
1 placed Call Pa Called
My Message Reply
Party's Message Reply
d
Action or Follow Up Necessary
No ?t-
Refer to: S le ! Z S -7 File #:
Signed:
U 00
Phone Conversation Record
Talked with: Date: Time:

Of State Historic Preservation Office Phone # : [phone]
Re: Filling &-5 sq. ft. of 404 wetlands under NWP in P ! l+ County.
I placed Call Party Called
My Message Reply
Party's Message Reply

d- U
Z)o r, o t- N'efot 4-0

Action or Follow Up Necessary
Refer to: 5g /a S File #:
Signed:
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001546
DWQ ID: CORPS ACTION ID:
llEr 14 20M
NATIONWIDE PERMIT REQUESTED (PROVIDE NATIONWIDE PERMIT #) 14
PRE-CONSTRUCTION NOTIFICATION APPLICATION
FOR NATIONWIDE PERMITS THAT REQUIRE:
1. NOTIFICATION TO THE CORPS OF ENGINEERS
2. APPLICATION FOR SECTION 401 CERTIFICATION
3. COORDINATION WITH THE NC DIVISION OF COASTAL MANAGEMENT
SEND THE ORIGINAL AND (1) COPY OF THIS COMPLETED FORM TO THE APPROPRIATE FIELD
OFFICE OF THE CORPS OF ENGINEERS (SEE AGENCY ADDRESSES SHEET). SEVEN L.L
COPIES MUST BE SENT TO THE NC DIVISION OF WATER QUALITY
ATTN: JOHN DORNEY, 4401 REEDY CREEK ROAD, RALEIGH, NC
27607. PLEASE PRINT OR TYPE. • .
1. OWNER'S NAME: NCDOT
2. MAILING ADDRESS: P.O. BOX 1587
SUBDIVISION NAME:
CITY: GREENVILLE STATE: N.C. ZIP CODE: 27835
PROJECT LOCATION ADDRESS, INCLUDING SUBDIVISION NAME (IF DIFFERENT FROM
MAILING ADDRESS ABOVE):
SR 1257 Pitt County
3. TELEPHONE NUMBER: (HOME) (WORK) 252-830-3490
4. IF APPLICABLE: AGENT'S NAME OR RESPONSIBLE CORPORATE OFFICIAL, ADDRESS,
PHONE NUMBER:
Jay Johnson, NCDOT Division 2 Environmental Officer.
5. LOCATION OF WORK (PROVIDE A MAP, PREFERABLY A COPY OF USGS TOPOGRAPHIC MAP
OR AERIAL PHOTOGRAPHY WITH SCALE):
COUNTY: Pitt - NEAREST TOWN: Bruce
USGS TOPO Greenville NW Quadrangle Lat: 77 29 08 Long: 35 39 25
SPECIFIC LOCATION (INCLUDE ROAD NUMBERS, LANDMARKS, ECT.) SR 1257 Cottondale road
6. IMPACTED OR NEAREST STREAM/RIVER: Lawrence Run Creek RIVER BASIN: Tar-Pam
? (a) IS PROJECT LOCATED NEAR WATER CLASSIFIED AS TROUT, TIDAL SALTWATER, (SA), HIGH
QUALITY WATERS (HQW), OUTSTANDING RESOURCE WATERS (ORW), WATER SUPPLY (WS-I
OR WS-II)? YES [_? NO x IF YES, EXPLAIN:
(b) IS THE PROJECT LOCATED WITHIN A NORTH CAROLINA DIVISION OF COASTAL
MANAGEMENT AREA OF ENVIRONMENTAL CONCERN (AEC)? YES ? NO x
CM-
-
"')
rn zi:
E rn
rn z
t= -I
(c) IF THE PROJECT IS LOCATED WITHIN A COASTAL COUNTY (SEE PAGE 7 FOR LIST OF
COASTAL COUNTIES), WHAT IS THE LAND USE PLAN (LUP) DESIGNATION? N/A
(a) HAVE ANY SECTION 404 PERMITS BEEN PREVIOUSLY REQUESTED FOR USE ON THIS
PROJECT? YES ? NO x IF YES, PROVIDE ACTION I.D. NUMBER OF PREVIOUS PERMIT AND
ANY ADDITIONAL INFORMATION (INCLUDE PHOTOCOPY OF 401 CERTIFICATION):
(b) ARE ADDITIONAL PERMIT REQUESTS EXPECTED FOR THIS PROPERTY IN THE FUTURE?
YES ? NO x IF YES, DESCRIBE ANTICIPATED WORK:
9. (a) ESTIMATED TOTAL NUMBERS OF ACRES IN TRACT OF LAND: N/A
(b) ESTIMATED TOTAL NUMBER OF ACRES OF WETLANDS LOCATED ON PROJECT SITE: N/A
10. (a) NUMBER OF ACRES OF WETLANDS IMPACTED BY THE PROPOSED PROJECT BY:
FILLING: .17 EXCAVATION:
FLOODING: OTHER :
DRAINAGE : TOTAL ACRES TO BE IMPACTED:. 17
(b) (1) STREAM CHANNEL TO BE IMPACTED BY THE PROPOSED PROJECT (IF RELOCATED,
PROVIDE DISTANCE BOTH BEFORE AND AFTER RELOCATION:
LENGTH BEFORE: FT AFTER: FT
WIDTH BEFORE (based on normal high water contours): FT
AVERAGE DEPTH BEFORE: 1 FT AFTER: 1 FT
(b) (2) STREAM CHANNEL IMPACTS WILL RESULT FROM: (CHECK ALL THAT APPLY)
OPEN CHANNEL RELOCATION: PLACEMENT OF PIPE IN CHANNEL: X_
CHANNEL EXCAVATION: X_ CONSTRUCTION OF A DAM/FLOODING:
OTHER:
11. IF CONSTRUCTION OF A POND IS PROPOSED, WHAT IS THE SIZE OF THE WATERSHED
DRAINING TO THE POND? WHAT IS THE EXPECTED POND SURFACE AREA?
12. DESCRIPTION OF PROPOSED WORK INCLUDING DISCUSSION OF TYPE OF MECHANICAL
EQUIPMENT TO BE USED? (ATTACH PLANS; 81/2 BY 11 DRAWINGS ONLY)
Grade, Base, and Pave road SR 1257 to end. Realign 1257
13. PURPOSE OF PROPOSED WORK: To widen and pave SR 1257
14. STATE REASONS WHY IT IS BELIEVED THAT THIS ACTIVITY MUST BE CARRIED OUT IN
WETLANDS (INCLUDE ANY MEASURES TAKEN TO MINIMIZE WETLAND IMPACTS)
There are wetlands on the realignment section of road. Only filline the areas needed to facilitate the new
road and safe shoulder slope.
15. YOU ARE REQUIRED TO CONTACT THE US FISH AND WILDLIFE SERVICE AND/OR
NATIONAL MARINE FISHERIES SERVICE REGARDING THE PRESENCE OF ANY FEDERALLY
LISTED OR PROPOSED FOR LISTING ENDANGERED OR THREATENED SPECIES OR CRITICAL
HABITAT IN THE PERMIT AREA THAT MAY BE AFFECTED BY THE PROPOSED PROJECT.
DATE CONTACTED: 11/16/2000
16. YOU ARE REQUIRED TO CONTACT THE STATE HISTORIC PRESERVATION OFFICER
(SHPO) REGARDING THE PRESENCE OF HISTORIC PROPERTIES IN THE PERMIT AREA
WHICH MAY BE AFFECTED BY THE PROPOSED PROJECT. DATE CONTACTED 11/16/2000.
17. DOES THE PROJECT INVOLVE AN EXPENDITURE OF PUBLIC FUNDS OT THE USE OF PUBLIC
(STATE) LAND? YES ® NO Fj (IF NO, GO TO 16)
(a) IF YES, DOES THE PROJECT REQUIRE PREPARATION OF AN ENVIRONMENTAL
DOCUMENT PURSUANT TO THE REQUIREMENTS OF THE NORTH CAROLINA
ENVIRONMENTAL POLICY ACT? YES 0 NO
(b) IF YES, HAS THE DOCUMENT BEEN REVIEWED THROUGH THE NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION STATE CLEARINGHOUSE YES 0 NO
IF ANSWER 17b IS YES, THEN SUBMIT APPROPRIATE DOCUMENTATION FROM THE STATE
CLEARINGHOUSE WITH THE NORTH CAROLINA ENVIRONMENTAL POLICY ACT.
QUESTIONS REGARDING THE STATE CLEARINGHOUSE REVIEW PROCESS SHOULD BE
DIRECTED TO MS. CHRYS BAGGETT, DIRECTOR STATE CLEARINGHOUSE, NORTH
CAROLINA DEPARTMENT OF ADMINISTRATION, 116 WEST JONES STREET, RALEIGH,
NORTH CAROLINA 27603-8003, TELEPHONE [phone]. R
18. THE FOLLOWING ITEMS SHOULD BE INCLUDED WITH THIS APPLICATION IF PROPOSED
ACTIVITY INVOLVES THE DISCHARGE OF EXCAVATED OF FILL MATERIAL INTO
WETLANDS:
(a) WETLAND DELINEATION MAP SHOWING ALL WETLANDS, STREAMS, LAKES, AND
PONDS ON THE PROPERTY (FOR NATIONWIDE PERMIT NUMBERS 14, 18, 21, 26, 29, AND 38).
ALL STREAM (INTERMITTENT AND PERMANENT) ON THE PROPERTY MUST BE SHOWN ON
THE MAP. MAP SCALES SHOULD BE 1 INCH EQUALS 50 FEET OF 1 INCH EQUALS 100 FEET
OF THEIR EQUIVALENT.
(b) IF AVAILABLE, REPRESENTATIVE PHOTOGRAPH OF WETLANDS TO BE IMPACTED BY
PRODUCT.
(c) IF DELINEATION WAS PERFORMED BY A CONSULTANT, INCLUDE ALL DATA SHEETS
RELEVANT TO THE PLACEMENT OF THE DELINEATION LINE.
(d) ATTACH A COPY OF THE STORMWATER MANAGEMENT PLAN IF REQUIRED.
(e) WHAT IS LAND USE OF SURROUNDING PROPERTY? Residential/Agriculture
(f) IF APPLICABLE, WHAT IS PROPOSED METHOD OF SEWAGE DISPOSAL? N/A
SIGNED AND DATED AGENT AUTHORIZATION LETTER, IF APPLICABLE.
NOTE: WETLANDS OR WATERS OF THE US MAY NOT BE IMPACTED PRIOR TO:
1. ISSUANCE OF A SECTION 404 CORPS OF ENGINEERS PERMIT,
2. EITHER THE ISSUANCE OR WAIVER OF A 401 DIVISION OF WATER QUALITY
CERTIFICATION, AND
3. (IN THE TWENTY COASTAL COUNTIES ONLY), A LETTER FROM THE NORTH
CAROLINA DIVISION OF COASTAL MANAGEMENT STATING THE PROPOSED
ACTIVITY IS CONSISTENT WITH THE NORTH CAROLINA COASTAL MANAGEMENT
PROGRAM, (??Ll
OWNER'S/AGENT'S SIGNATURE DATE
(AGENT'S SIGNATURE VALID ONLY
IF AUTHORIZATION LETTER FROM
THE OWNER IS PROVIDED).
j
, /'" _ , ?A... °'? .. , ?('?- ? ?_. 1 f _? ?` J ?r8'IR8.6. -.? .ter"'. -•?- -,e,, y A 'Cem?
?.:?? 1 .?. ?.i ??t y? +r. ??i?. 4v??. \`\
777-' t} Bruce
245
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"?
DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Delineation Manual)
Project/Site: -?? 12 12 67 _ Date: i
Applicant/Owner: N C DT County: ! f¢
Investigator: ?o?nr+Jav? State: N •?-' • _
Do Normal Circumstances exist on the site? ?`s7 No Community ID:
Is the site significantly disturbed (Atypical Situation)? Yes duo Transect ID:
Is the area a potential Problem Area? Yeso Plot ID:
If needed, explain on reverse.
VEGETATION
Do 'nant Plant Species Stratum Indicator Dominant Plant Soecies Stratum Indicator
2.td?K??F

5.
--
-?-- ----
13.
--
6. --- -
--- -- -- - -
14.

7.-
8.-- - -

---- --- - -
15. _
16.- --
- --
Percent of Dominant Species that are OBL. FACW or FAC
(excluding FAC-).
S5 -a -":k --------------------------------
Remarks: 4,A1 Q?/ vea" • f S '4 +' Q S C4, f
HYDROLOGY
- Recorded Data (Describe in Remarks):
_ Stream, Lake, or Tide Gauge
Aerial Photographs
_ ,<&r
-cNo Recorded Data Available Wetland Hydrology Indicators:
Primary Indicators:
_ Inundated
- Saturated in Upper 12 Inches
_ Water Marks
_ Drift Lines
Sediment Deposits
Field Observations: _
_ Drainage Patterns in Wetlands

- Secondary Indicators (2 or more required):
Depth of Surface Water. ? (in.) _ Oxidized Root Channels in Upper 12 Inches
_ Water-Stained Leaves
Depth to Free Water in Pit: (in.) - Local Soil Survey Data
_ FAC-Neutral Test
Depth to Saturated Soil: (in.) - Other (Explain in Remarks)
Remarks: -? f! M
p(v dLo q `/ j S ?rC grs
Y
E32 Appendix B Blank and Example Data Forms
SOILS
Map Unit Name !? q
(Series and Phase): Drainage Class:
Taxonomy (Subgroup): Field Observations
y ?r G ?F4o???/S __ Confirm Mapped Type? Yes No
Profile Description: `?-
Depth Matrix Color Mottle Colors Mottle Abundance/ Texture, Concretions,
(inches) Horizon (Munsell Moist) (Munsell Moist) Size/Contrast Structure. etc.
Hydric Soil Indicators:
t
H'istosol _ C retions -on
Histic don -nigh Organic Content in Surface. Layer in Sandy Soils
Sulfdic Odor Organic Streaking in Sandy Soils
Agyic Moisture Regime _?tf4Ced on Local Hydric Soils List
_-Reducing Conditions _%kisted on National Hydric Soils List
1`Gleyed or Low-Chroma Colors ` Other (Explain in Remarks)
Remarks: WCAL I a "J
?o S ?w-2_ r? re
WETLAND DETERMINATION
Hydrophytic Vegetation Present? ® No (Circle) (Circle)
Wetland Hydrology Present? No
Hydric Soils Present? s No Is this Sampling Point Within a Wetland? ee No
Remarks: 0"J Approved by HQUSACE 3/92

Appendix B Blank and Example Data Forms B3

DATA FORM
ROUTINE WETLAND DETERMINATION
(1987 COE Wetlands Delineation Manual)
Project/Site: 512 1257 Date: /I i o0
Applicant/Owner: &q DQT' County: f i
Investigator: State: - C_.?__--
Do Normal Circumstances exist on the site? dZZP No Community ID:
Is the site significantly disturbed (Atypical Situation)? Yes (? Transect ID:
Is the area a potential Problem Area? Yes (t Co
_)
Plot ID: ?-
If needed, explain on reverse.) .
I
VEGETATION
Dominant Plant Soecies Stratum Indicator Dominant Plant Species tratum Indicator
2. -4
10.
tp.
12.
5. 1&6-
6.

14.
--
7.-- --- - --
--- - - - --
15.

8.--- - -- -
----- -- - --- -- -
16.- - --- -- -- --
Percent of Dominant Species that are OBL. FACW or FAC
(excluding FAG-).
Remarks: oj'e ?-t Ov?p? 1f 2 c +r??,CI [n.? l 5 Yoe,.
HYDROLOGY
- Recorded Data (Describe in Remarks):
- Stream. Lake, or Tide Gauge
-Aerial Photographs
?ther
- No Recorded Data Available Wetland Hydrology Indicators:
Primary Indicators:
_ Inundated
- Saturated in Upper 12 Inches
_ Water Marks
_ Drift Lines
- Sediment Deposits
Field Observations: _ Drainage Patterns in Wetlands
Secondary Indicators (2 or more required):
Depth of Surface Water: '-? (in.) - Oxidized Root Channels in Upper 12 Inches

l _ Water-Stained Leaves
Depth to Free Water in Pit: (in.) - Local Soil Survey Data
_ FAC-Neutral Test
Depth to Saturated Soil: _ (in.) - Other (Explain in Remarks)
Remarks: ?+Z.}..?cw?? t??A??OJy f.S lJdl pr?51LY?.?
B2 Appendix B Blank and Example Data Forms
SOILS
Map Unit Name
(Series and Phase):eO-Gt-S ?'??' bs? s"'? °O"? Drainage Class:
J _- Field Observations
Taxonomy (Subgroup):?Ssu??S - Confirm Mapped Type? Yes No
Profile Descriotion: '
Depth Matrix Color Mottle Colors Mottle Abundance/ Texture. Concretions.
(inches) Horizon (Munsell Moist) (Munsell Moist) Size/Contrast Structure, etc.
0-7 U yea
Hydric Soil Indicators: t
- HistosoI Concretions
- Histic Epipedon - High Organic Content in Surface Layer in Sandy Soils
- Sulfidic Odor Organic Streaking in Sandy Soils
Aquic Moisture Regime Listed on Local Hydric Soils List
_ Reducing Conditions - Listed on National Hydric Soils List
- Gleyed or Low-Ch/roma Colors - Other (Explain in Remarks)
Remarks: w ¢. ?- f qw,? j C? O 'l. ?j G L-e_ N.j o-?- ,p ??L^yQ..?.?
WETLAND DETERMINATION
I-lydrophytic Vegetation Present? ® No (Circle) (Circle)
Wetland Hydrology Present? Yes (M)
Hydric Soils Present? Yes t® Is this Sampling Point Within a Wetland? Yes
Remarks:
-D
v -p-
Approved by HQUSACE 3192
Appendix B Blank and Example Data Forms B3
Phone Conversation Record
Talked with:
"
NY,VQIv Date:
/
/1//1 /;2z vo Time:

10, 100

PM
Of: National Marine Fisheries Phone # : [phone]
Re: Filling 7a? sq. ft. of 404 wetlands under NWP in ?? County.
I placed Call Pa Called
My Message Reply
Parry's Message Reply
d
Action or Follow Up Necessary
N o rt <.-
Refer to: Ste 125-7 File #
Signed:
U 0p
Phone Conversation Record
Talked with: Date: Time:
//
Of: State Historic Preservation Office Phone # : [phone]
Re: Filling Za&.s sq. ft. of 404 wetlands under NWP in P ! 7? County.
I placed Call Party Called
My Message Reply
Party's Message- Reply
?? r o ?" ? ?; KrLI v S? r? L+a.?o T wo ! u r Il/y`?'-'

Action or Follow Up Necessary
cr+-?.?
Refer to: 5 R /v2 5 -7 File #:
Signed:
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